International IgAN Prediction Tool at biopsy - Pediatrics

Determine prognosis in children in IgA nephropathy

About

The risk equations were derived in a multi-ethnic international cohort of 1,060 children with biopsy proven idiopathic IgA nephropathy and are designed to predict the risk of a 30% decline in eGFR or ESRD after biopsy.

The International IgAN Prediction Tool for adults was modified and updated to predict disease progression in children. There are two models, one that includes race and one that does not. If the patient’s race is not adequately represented by Chinese patients from China, Japanese patients from Japan, or Caucasian patients from Europe or North America, then we suggest using the model without race to predict the outcome. As such, this app uses the model with race if Chinese, Japanese or Caucasian race is selected, and uses the model without race if Other race is selected. Several variable transformations occur within the app calculator as follows: 1) estimated GFR is calculated based on the full age spectrum formula using height developed by Pottel et al; 2) height and weight are used to calculate body surface area using the Dubois formula; 3) mean arterial blood pressure is normalized to adult values using the standard deviation score and the method proposed by Wuhl et al; and 4) proteinuria is normalized to body surface area (grams/day/1.73m2).

The C-statistic for both models were 0.74 and 0.68, and both models were well calibrated. The C-statistics did not appreciably change after internal validation. The pediatric International IgAN Prediction Tool models require additional external validation.

References

Barbour SJ, Coppo R, et al.

The International IgA Nephropathy Network. November 17, 2020

Pottel H, Hoste L, Dubourg L, et al.

Nephrol Dial Transplant. 2016;31(5):798-806

Wuhl E, Witte K, Soergel M, Mehls O, Schaefer F, German Working Group on Pediatric H.

J Hypertens. 2002;20(10):1995-2007

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1. Age at biopsy

Years
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