Nomogram for the prediction of crescent formation in IgA nephropathy patients: a retrospective study

Background The 2017 Oxford classification of immunoglobulin A nephropathy (IgAN) recently reported that crescents could predict a worse renal outcome. Early prediction of crescent formation can help physicians determine the appropriate intervention, and thus, improve the outcomes. Therefore, we aime...

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Published in:BMC nephrology 2023-09, Vol.24 (1), p.1-262, Article 262
Main Authors: Lin, Zaoqiang, Feng, Liuchang, Zeng, Huan, Lin, Xuefei, Lin, Qizhan, Lu, Fuhua, Wang, Lixin, Mai, Jianling, Fang, Pingjun, Liu, Xusheng, Tan, Qinxiang, Zou, Chuan
Format: Article
Language:English
Subjects:
Analysis
Atrophy
Biopsy
Body mass index
Care and treatment
Crescent
Diagnosis
Erythrocytes
Histology, Pathological
IgA glomerulonephritis
IgA nephropathy
Immunoglobulin A
Kidney diseases
Medical research
Medicine, Experimental
Nephrology
Nomogram
Nomograms
Nomography (Mathematics)
Prediction
Predictions
Prognosis
Proteins
Regression analysis
Risk factors
Variables
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Summary:Background The 2017 Oxford classification of immunoglobulin A nephropathy (IgAN) recently reported that crescents could predict a worse renal outcome. Early prediction of crescent formation can help physicians determine the appropriate intervention, and thus, improve the outcomes. Therefore, we aimed to establish a nomogram model for the prediction of crescent formation in IgA nephropathy patients. Methods We retrospectively analyzed 200 cases of biopsy-proven IgAN patients. Least absolute shrinkage and selection operator(LASSO) regression and multivariate logistic regression was applied to screen for influencing factors of crescent formation in IgAN patients. The performance of the proposed nomogram was evaluated based on Harrell's concordance index (C-index), calibration plot, and decision curve analysis. Results Multivariate logistic analysis showed that urinary protein [greater than or equal to] 1 g (OR = 3.129, 95%CI = 1.454-6.732), urinary red blood cell (URBC) counts [greater than or equal to] 30/ul (OR = 3.190, 95%CI = 1.590-6.402), mALBU [greater than or equal to] 1500 mg/L(OR = 2.330, 95%CI = 1.008-5.386), eGFR < 60ml/min/1.73m.sup.2(OR = 2.295, 95%CI = 1.016-5.187), Serum IgA/C3 ratio [greater than or equal to] 2.59 (OR = 2.505, 95%CI = 1.241-5.057), were independent risk factors for crescent formation. Incorporating these factors, our model achieved well-fitted calibration curves and a good C-index of 0.776 (95%CI [0.711-0.840]) in predicting crescent formation. Conclusions Our nomogram showed good calibration and was effective in predicting crescent formation risk in IgAN patients. Keywords: IgA nephropathy, Crescent, Prediction, Nomogram
ISSN:1471-2369
1471-2369
DOI:10.1186/s12882-023-03310-2