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External validation of the international prediction tool in Korean patients with immunoglobulin A nephropathy

Authors
 Young Su Joo  ;  Hyung Woo Kim  ;  Chung Hee Baek  ;  Jung Tak Park  ;  Hajeong Lee  ;  Beom Jin Lim  ;  Tae-Hyun Yoo  ;  Kyung Chul Moon  ;  Ho Jun Chin  ;  Shin-Wook Kang  ;  Seung Hyeok Han 
Citation
 KIDNEY RESEARCH AND CLINICAL PRACTICE, Vol.41(5) : 556-566, 2022-09 
Journal Title
KIDNEY RESEARCH AND CLINICAL PRACTICE
ISSN
 2211-9132 
Issue Date
2022-09
Keywords
External validation ; IgA nephropathy ; International prediction tool ; Prediction model ; Renal insufficiency ; Risk factors
Abstract
Background: The International IgA Nephropathy Prediction Tool has been recently developed to estimate the progression risk of immunoglobulin A nephropathy (IgAN). This study aimed to evaluate the clinical performance of this prediction tool in a large IgAN cohort in Korea.

Methods: The study cohort was comprised of 2,064 patients with biopsy-proven IgAN from four medical centers between March 2012 and September 2021. We calculated the predicted risk for each patient. The primary outcome was occurrence of a 50% decline in estimated glomerular filtration rate (eGFR) from the time of biopsy or end-stage kidney disease. The model performance was evaluated for discrimination, calibration, and reclassification. We also constructed and tested an additional model with a new coefficient for the Korean race.

Results: During a median follow-up period of 3.8 years (interquartile range, 1.8-6.6 years), 363 patients developed the primary outcome. The two prediction models exhibited good discrimination power, with a C-statistic of 0.81. The two models generally underestimated the risk of the primary outcome, with lesser underestimation for the model with race. The model with race showed better performance in reclassification compared to the model without race (net reclassification index, 0.13). The updated model with the Korean coefficient showed good agreement between predicted risk and observed outcome.

Conclusion: In Korean IgAN patients, International IgA Nephropathy Prediction Tool had good discrimination power but underestimated the risk of progression. The updated model with the Korean coefficient showed acceptable calibration and warrants external validation.
Files in This Item:
T202204284.pdf Download
DOI
10.23876/j.krcp.22.006
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Hyung Woo(김형우) ORCID logo https://orcid.org/0000-0002-6305-452X
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
Joo, Young Su(주영수) ORCID logo https://orcid.org/0000-0002-7890-0928
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191948
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