Validation of an international prediction model including the Oxford classification in Korean patients with IgA nephropathy. Issue 7 (3rd March 2021)

• Record Type: Journal Article
• Authors: Hwang, Dohui; Choi, Kyoungjin; Cho, Nam‐Jun; Park, Samel; Yu, Byung Chul; Gil, Hyo‐Wook; Lee, Eun Young; Choi, Soo Jeong; Park, Moo Yong; Kim, Jin Kuk; Hwang, Seung Duk; Kwon, Soon Hyo; Jeon, Jin Seok; Noh, Hyunjin; Han, Dong Cheol; Kim, Hyoungnae
• Is Part Of: Nephrology. Volume 26:Issue 7(2021)
• Page Start: 594
• Page End: 602
• Publication Date: 2021-03-03
• Subjects: clinical decision‐making -- glomerulonephritis -- IgA -- Koreans -- validation study; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13865
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Background: Recently, a new international risk prediction model including the Oxford classification was published which was validated in a large multi‐ethnic cohort. Therefore, we aimed to validate this risk prediction model in Korean patients with IgA nephropathy. Methods: This retrospective cohort study was conducted with 545 patients who diagnosed IgA nephropathy with renal biopsy in three medical centers. The primary outcome was defined as a reduction in estimated glomerular filtration rate (eGFR) of >50% or incident end‐stage renal disease (ESRD). Continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) were used to validate models. Results: During the median 3.6 years of follow‐up period, 53 (9.7%) renal events occurred. In multivariable Cox regression model, M1 (hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.02–4.82; p = .043), T1 (HR, 2.98; 95% CI, 1.39–6.39; p = .005) and T2 (HR, 4.80; 95% CI, 2.06–11.18; p < .001) lesions were associated with increased risk of renal outcome. When applied the international prediction model, the area under curve (AUC) for 5‐year risk of renal outcome was 0.69, which was lower than previous validation and internally derived models. Moreover, cNRI and IDI analyses showed that discrimination and reclassification performance of the international model was inferior to the internally derived models. Conclusion: The international risk prediction model for IgA nephropathy showed not as good performance in Korean patients as previous validation in other ethnic group. Further validation of risk prediction model is needed for Korean patients with IgA nephropathy. SUMMARY AT A GLANCE: Prediction models for IgA nephropathy using clinical variables and the Oxford MEST scores were developed and may be utilised to individualise risk of progression. This study evaluates the performance of these prediction models in an external cohort of Korean patients.