International IgAN Prediction Tool - Pediatrics

Determine prognosis in children in IgA nephropathy

Questions

1.Age at biopsy
2.Sex
3.Height at biopsy?
4.Weight at biopsy?
5.Proteinuria based on a 24-hour collection?
6.Urine protein to creatinine ratio if a 24-hour collection is not available?
7.Serum Creatinine at biopsy?
8.Systolic blood pressure at biopsy
9.Diastolic blood pressure at biopsy
10.Race
11.Use of ACE inhibitor or ARB at the time of biopsy
12.MEST M-score
13.MEST E-score
14.MEST S-score
15.MEST T-score
16.Immunosuppression use at or prior to biopsy
17.At how many months after renal biopsy would you like to determine risk of renal progression?

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.

Updating the International IgA Nephropathy Prediction Tool for use in pediatric patients. JAMA Pediatrics.

The International IgA Nephropathy Network. November 17, 2020

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

An estimated glomerular filtration rate equation for the full age spectrum.

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

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

Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions.

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

The International IgAN Prediction Tool - Pediatrics calculator is created by QxMD.

Created by on 18/02/2020

By using this site you acknowledge that you have read, understand, and agree to be bound by our terms of use and privacy policy. All content and tools are for educational use only, are not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.

1. Age at biopsy

Years
0/17 completed