- •Studies on acute kidney injury (AKI) in the IgA nephropathy (IgAN) are limited.
- •We studied the effect of AKI on the progression of renal disease in IgAN patients.
- •IgAN patients with AKI had a poor survival outcome than those without AKI.
- •IgAN patients with AKI had 2.84 times higher risk of the composite renal endpoint.
- •A nomogram was developed for predicting the renal outcome in the IgAN patients.
This study aimed to investigate the effect of acute kidney injury (AKI) on the progression of renal disease and to develop a clinico-pathological nomogram to predict the renal outcome of IgA nephropathy (IgAN) patients, based on Oxford classification score.
This is a retrospective observational study. A total of 988 IgAN patients treated at our hospital between 2006 and 2011 were included and divided into AKI (n = 82) and non-AKI group (n = 906). The primary outcome measure was the composite renal endpoint. The secondary outcome measure was all-cause mortality. Clinical and pathologic features were assessed with multivariable Cox regression to predict the outcome in IgAN patients. A nomogram was developed to predict the renal outcome.
The median follow-up time was 48.6 months (range: 34.4 to 62.7). The incidence of AKI was 8.30%. The AKI group had more severe pathological characteristics and a significantly poor survival outcome than the non-AKI group. The multivariate Cox regression analysis showed that the AKI group had a 2.84 times higher risk of the composite renal endpoint as compared with the non-AKI group (P < 0.001). A clinico-pathological nomogram was developed using the seven predictors for the primary renal composite endpoint. The AUC for the nomogram model was 0.81 (sensitivity = 0.78, specificity = 0.85), and the C-index was 0.91 (95% CI = 0.85–0.97).
For IgAN patients, AKI is an independent risk factor for the progression of renal disease. Our nomogram model has good prediction power for the renal outcome of IgAN patients.
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Published online: February 03, 2018
Accepted: January 23, 2018
Received in revised form: January 14, 2018
Received: November 3, 2017
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.