International IgAN Prediction Tool at biopsy - Pediatrics
Determine prognosis in children in IgA nephropathy
Most users will use a 60-month (5-year) risk horizon.
Enter any negative number if not available.
Enter any negative number if a 24-hour urine result was entered instead
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.
- [1]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
- [2]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
- [3]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
Results
Real-time automated computation
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.
- [1]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
- [2]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
- [3]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