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Validation of an international prediction model including the Oxford classification in Korean patients with IgA nephropathy
Author(s) -
Hwang Dohui,
Choi Kyoungjin,
Cho NamJun,
Park Samel,
Yu Byung Chul,
Gil HyoWook,
Lee Eun Young,
Choi Soo Jeong,
Park Moo Yong,
Kim Jin Kuk,
Hwang Seung Duk,
Kwon Soon Hyo,
Jeon Jin Seok,
Noh Hyunjin,
Han Dong Cheol,
Kim Hyoungnae
Publication year - 2021
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13865
Subject(s) - medicine , hazard ratio , nephropathy , proportional hazards model , cohort , renal function , confidence interval , logistic regression , retrospective cohort study , diabetes mellitus , endocrinology
Background Recently, a new international risk prediction model including the Oxford classification was published which was validated in a large multi‐ethnic cohort. Therefore, we aimed to validate this risk prediction model in Korean patients with IgA nephropathy. Methods This retrospective cohort study was conducted with 545 patients who diagnosed IgA nephropathy with renal biopsy in three medical centers. The primary outcome was defined as a reduction in estimated glomerular filtration rate (eGFR) of >50% or incident end‐stage renal disease (ESRD). Continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) were used to validate models. Results During the median 3.6 years of follow‐up period, 53 (9.7%) renal events occurred. In multivariable Cox regression model, M1 (hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.02–4.82; p = .043), T1 (HR, 2.98; 95% CI, 1.39–6.39; p = .005) and T2 (HR, 4.80; 95% CI, 2.06–11.18; p < .001) lesions were associated with increased risk of renal outcome. When applied the international prediction model, the area under curve (AUC) for 5‐year risk of renal outcome was 0.69, which was lower than previous validation and internally derived models. Moreover, cNRI and IDI analyses showed that discrimination and reclassification performance of the international model was inferior to the internally derived models. Conclusion The international risk prediction model for IgA nephropathy showed not as good performance in Korean patients as previous validation in other ethnic group. Further validation of risk prediction model is needed for Korean patients with IgA nephropathy.