Development and validation of a nomogram to predict kidney survival at baseline in patients with C3 glomerulopathy
Por:
Caravaca-Fontan, F, Rivero, M, Cavero, T, Diaz-Encarnacion, M, Cabello, V, Ariceta, G, Quintana, L, Marco, H, Barros, X, Ramos, N, Rodriguez-Mendiola, N, Cruz, S, Fernandez-Juarez, G, Rodriguez, A, de Jose, A, Rabasco, C, Rodado, R, Fernandez, L, Perez-Gomez, V, Avila, A, Bravo, L, Espinosa, N, Allende, N, de la Nieta, M, Rodriguez, E, Olea, T, Melgosa, M, Huerta, A, Miquel, R, Mon, C, Fraga, G, de Lorenzo, A, Draibe, J, Gonzalez, F, Shabaka, A, Lopez-Rubio, M, Fenollosa, M, Martin-Penagos, L, Da Silva, I, Titos, J, de Cordoba, S, de Jorge, E and Praga, M
Publicada:
22 ago 2022
Ahead of Print:
1 abr 2022
Resumen:
Background C3 glomerulopathy is a rare and heterogeneous complement-driven disease. It is often challenging to accurately predict in clinical practice the individual kidney prognosis at baseline. We herein sought to develop and validate a prognostic nomogram to predict long-term kidney survival. Methods We conducted a retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. The dataset was randomly divided into a training group (n = 87) and a validation group (n = 28). The least absolute shrinkage and selection operator (LASSO) regression was used to screen the main predictors of kidney outcome and to build the nomogram. The accuracy of the nomogram was assessed by discrimination and risk calibration in the training and validation sets. Results The study group comprised 115 patients, of whom 46 (40%) reached kidney failure in a median follow-up of 49 months (range 24-112). No significant differences were observed in baseline estimated glomerular filtration rate (eGFR), proteinuria or total chronicity score of kidney biopsies, between patients in the training versus those in the validation set. The selected variables by LASSO were eGFR, proteinuria and total chronicity score. Based on a Cox model, a nomogram was developed for the prediction of kidney survival at 1, 2, 5 and 10 years from diagnosis. The C-index of the nomogram was 0.860 (95% confidence interval 0.834-0.887) and calibration plots showed optimal agreement between predicted and observed outcomes. Conclusions We constructed and validated a practical nomogram with good discrimination and calibration to predict the risk of kidney failure in C3 glomerulopathy patients at 1, 2, 5 and 10 years.
Filiaciones:
Caravaca-Fontan, F:
Inst Invest Hosp 12 Octubre, Madrid, Spain
Univ Complutense Madrid, Dept Med, Madrid, Spain
Rivero, M:
Hosp Univ 12 Octubre, Dept Nephrol, Madrid, Spain
Cavero, T:
Hosp Univ 12 Octubre, Dept Nephrol, Madrid, Spain
Diaz-Encarnacion, M:
Fdn Puigvert, Dept Nephrol, Barcelona, Spain
Cabello, V:
Hosp Univ Virgen del Rocio, Dept Nephrol, Seville, Spain
Ariceta, G:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Dept Pediat Nephrol, Barcelona, Spain
Quintana, L:
Univ Barcelona, Hosp Clin Barcelona, Dept Nephrol & Renal Transplantat, IDIBAPS, Barcelona, Spain
Univ Barcelona, Dept Med, IDIBAPS, Barcelona, Spain
Marco, H:
Fdn Puigvert, Dept Nephrol, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Barcelona, Spain
Barros, X:
Hosp Univ Doctor Josep Trueta, Dept Nephrol, Girona, Spain
Ramos, N:
Hosp Univ Vall dHebron, Dept Nephrol, Barcelona, Spain
Rodriguez-Mendiola, N:
Hosp Univ Ramon y Cajal, Dept Nephrol, Madrid, Spain
Cruz, S:
Hosp Univ Juan Ramon Jimenez, Dept Nephrol, Huelva, Spain
Fernandez-Juarez, G:
Hosp Univ Fdn Alcorcon, Dept Nephrol, Madrid, Spain
Rodriguez, A:
Hosp Univ Virgen del Rocio, Dept Pediat Nephrol, Seville, Spain
de Jose, A:
Hosp Univ Gregorio Maranon, Dept Nephrol, Madrid, Spain
Rabasco, C:
Hosp Univ Reina Sofia, Dept Nephrol, Cordoba, Spain
Rodado, R:
Hosp Univ Virgen de la Arrixaca, Dept Nephrol, Murcia, Spain
Fernandez, L:
Complejo Hosp Navarra, Dept Nephrol, Navarra, Spain
Perez-Gomez, V:
Hosp Univ Fdn Jimenez Diaz, Dept Nephrol, Madrid, Spain
:
Hosp Univ Doctor Peset, Dept Nephrol, Valencia, Spain
Bravo, L:
Hosp Univ A Coruna, Dept Nephrol, La Coruna, Spain
Espinosa, N:
Hosp Univ Son Espases, Balearic Isl Hlth Res Inst IdISBa, Pediat Nephrol Unit, Palma De Mallorca, Spain
Allende, N:
Hosp Univ Son Espases, Dept Nephrol, Palma De Mallorca, Spain
de la Nieta, M:
Hosp Gen Univ Ciudad Real, Dept Nephrol, Ciudad Real, Spain
Rodriguez, E:
Hosp del Mar, Dept Nephrol, Barcelona, Spain
Olea, T:
Hosp Univ La Paz, Dept Nephrol, Madrid, Spain
Melgosa, M:
Hosp Univ La Paz, Dept Pediat Nephrol, Madrid, Spain
Huerta, A:
Hosp Univ Puerta de Hierro, Dept Nephrol, Madrid, Spain
Miquel, R:
Hosp Univ Canarias, Dept Nephrol, Tenerife, Spain
Mon, C:
Hosp Univ Severo Ochoa, Dept Nephrol, Madrid, Spain
Fraga, G:
Univ Autonoma Barcelona, Dept Pediat Nephrol, Hosp Santa Creu & St Pau, Barcelona, Spain
de Lorenzo, A:
Hosp Univ Getafe, Dept Nephrol, Madrid, Spain
Draibe, J:
Hosp Univ Bellvitge, Dept Nephrol, Barcelona, Spain
Gonzalez, F:
Hosp Doctor Negrin, Dept Nephrol, Gran Canaria, Spain
Shabaka, A:
Hosp Univ Clin San Carlos, Dept Nephrol, Madrid, Spain
Lopez-Rubio, M:
Complejo Hosp Univ Albacete, Dept Nephrol, Albacete, Spain
:
Hosp Gen Univ Castellon, Dept Nephrol, Castellon de La Plana, Spain
Martin-Penagos, L:
Hosp Univ Marques de Valdecilla, Dept Nephrol, Santander, Spain
Da Silva, I:
Fdn Puigvert, Dept Nephrol, Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Barcelona, Spain
Titos, J:
Hosp Reg Univ Carlos Haya, Dept Nephrol, Malaga, Spain
de Cordoba, S:
CSIC, Ctr Invest Biol, Madrid, Spain
Ctr Invest Biomed Red Enfermedades Raras, Madrid, Spain
de Jorge, E:
Inst Invest Hosp 12 Octubre, Madrid, Spain
Univ Complutense Madrid, Dept Immunol, Madrid, Spain
Praga, M:
Inst Invest Hosp 12 Octubre, Madrid, Spain
Univ Complutense Madrid, Dept Med, Madrid, Spain
Hosp Univ 12 Octubre, Dept Nephrol, Madrid, Spain
Green Published, gold
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