Development and validation of a diagnostic nomogram to evaluate tubular atrophy/interstitial fibrosis of IgA nephropathy

Gan, Yangang; Cai, Yihuan; Li, Jiajia; Wu, Jianping; Zhang, Rui; Han, Qianqian; Li, Wenchao; Yang, Qiongqiong

doi:10.7150/ijms.91804

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Int J Med Sci 2024; 21(4):674-680. doi:10.7150/ijms.91804 This issue Cite

Research Paper

Development and validation of a diagnostic nomogram to evaluate tubular atrophy/interstitial fibrosis of IgA nephropathy

Yangang Gan^†, Yihuan Cai^†, Jiajia Li, Jianping Wu, Rui Zhang, Qianqian Han, Wenchao Li, Qiongqiong Yang^✉

Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
^† These authors contributed equally to this work.

Citation:

Gan Y, Cai Y, Li J, Wu J, Zhang R, Han Q, Li W, Yang Q. Development and validation of a diagnostic nomogram to evaluate tubular atrophy/interstitial fibrosis of IgA nephropathy. Int J Med Sci 2024; 21(4):674-680. doi:10.7150/ijms.91804. https://www.medsci.org/v21p0674.htm

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Abstract

Background: IgA nephropathy (IgAN) is a cause of chronic kidney disease (CKD). Tubular atrophy/interstitial fibrosis is associated with IgAN prognosis. However, simple tools for predicting pathological lesions of IgAN remain limited. Our objective was to develop a tool for evaluating tubular atrophy/interstitial fibrosis in patients with IgAN.

Methods: In this cross-sectional study, 410 biopsy-verified IgAN patients were included. The factors associated with the incident interstitial fibrosis or tubular atrophy in IgAN were confirmed by using logistic regression analysis. A nomogram was developed using logistic regression coefficients to evaluate tubular atrophy or interstitial fibrosis. Receiver operating characteristic curves (ROC) and calibration curves were used to determine the discriminative ability and predictive accuracy of the nomogram.

Results: In this study, the IgAN patients with tubular atrophy or interstitial fibrosis were older and had a higher percentage of males, hypertension and urinary protein excretion (UPE), with high levels of serum cystatin C, serum creatinine, high-sensitivity C-reactive protein and serum C4. The eGFRcr-cys equation calculated using serum creatinine, cystatin C and UPE were considered independent influencing factors of tubular atrophy or interstitial fibrosis in patients with IgAN. Furthermore, the nomogram demonstrated good discrimination (AUC: 0.87, 95% CI 0.81 to 0.93) and calibration in the validation cohort.

Conclusion: The eGFRcr-cys and UPE are associated with tubular atrophy or interstitial fibrosis in patients with IgAN. Diagnostic nomogram can predict tubular atrophy or interstitial fibrosis in IgAN.

Keywords: estimated glomerular filtration rate, IgA nephropathy, nomogram, pathological change

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APA

Gan, Y., Cai, Y., Li, J., Wu, J., Zhang, R., Han, Q., Li, W., Yang, Q. (2024). Development and validation of a diagnostic nomogram to evaluate tubular atrophy/interstitial fibrosis of IgA nephropathy. International Journal of Medical Sciences, 21(4), 674-680. https://doi.org/10.7150/ijms.91804.

ACS

Gan, Y.; Cai, Y.; Li, J.; Wu, J.; Zhang, R.; Han, Q.; Li, W.; Yang, Q. Development and validation of a diagnostic nomogram to evaluate tubular atrophy/interstitial fibrosis of IgA nephropathy. Int. J. Med. Sci. 2024, 21 (4), 674-680. DOI: 10.7150/ijms.91804.

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CSE

Gan Y, Cai Y, Li J, Wu J, Zhang R, Han Q, Li W, Yang Q. 2024. Development and validation of a diagnostic nomogram to evaluate tubular atrophy/interstitial fibrosis of IgA nephropathy. Int J Med Sci. 21(4):674-680.

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