Utility of the 2018 revised ISN/RPS thresholds for glomerular crescents in childhood-onset lupus nephritis: a Pediatric Nephrology Research Consortium study

Autor: Pooja Patel, Marietta de Guzman, M. John Hicks, Joseph G. Maliakkal, Michelle N. Rheault, David T. Selewski, Katherine Twombley, Jason M. Misurac, Cheryl L. Tran, Alexandru R. Constantinescu, Ali M. Onder, Meredith Seamon, Wacharee Seeherunvong, Vaishali Singh, Cynthia Pan, Daryl M. Okamura, Abiodun Omoloja, Mahmoud Kallash, William E. Smoyer, Guillermo Hidalgo, Scott E. Wenderfer
Rok vydání: 2022
Předmět:
Zdroj: Pediatric Nephrology. 37:3139-3145
ISSN: 1432-198X
0931-041X
Popis: The revised 2018 ISN/RPS Classification System for lupus nephritis (LN) includes calculations for both activity index (A.I.) and chronicity index (C.I.). Unchanged were the thresholds of 25%, 25-50%, and 50% crescents to distinguish between mild, moderate, and severe activity/chronicity. We aimed to evaluate these thresholds for percent crescents in childhood-onset LN.Eighty-six subjects 21 years of age were enrolled from the Pediatric Glomerulonephritis with Crescents Registry, a retrospective multi-center cohort sponsored by the Pediatric Nephrology Research Consortium. Thresholds of 10%, 25%, and 50% for both cellular/fibrocellular and fibrous crescents were interrogated for primary outcomes of kidney failure, eGFR, and eGFR slope.Median age at time of initial biopsy was 14 years (range 1-21). Median follow-up time was 3 years (range 1-11). Cumulative incidence of kidney failure was 6% at 1 year and 10% at latest follow-up. Median eGFR slope was - 18 mL/1.73 mIn children with crescentic LN, use of 10% and 25% thresholds for cellular crescents better reflects disease activity, while these thresholds for fibrous crescents better discriminates kidney disease outcomes. A higher resolution version of the Graphical abstract is available as Supplementary information.
Databáze: OpenAIRE
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