P0412VALUE OF INTERNATIONAL RISK-PREDICTION TOOL IN IGA NEPHROAPTHY : A SINGLE CENTRE STUDY

Abstract Background and Aims A new International Risk-Prediction Tool in IgA Nephropathy developed was recently developed to help predict disease progression over a 5-7 year period1. We tested use of this Risk-Prediction Calculator in patients diagnosed with IgA Nephropathy to stratify the risk and predict outcomes during follow up. Method All adult patients (aged ≥18years) with biopsy proven IgA Nephropathy diagnosed between 2011 and 2016 at Manchester University NHS Foundation Trust were included in the study. Exclusion criteria included patients with secondary causes, prior exposure to immunosuppression, or presentation eGFR of less that 15ml/min. Demographic, clinical phenotypic & renal histological characteristics (MEST score) at baseline were used to calculate the individual risk scores. These risk scores were compared with outcomes seen during subsequent follow up. Primary outcome was a composite of first ESRD or reduction in eGFR to below 50% of value at biopsy. Patients were censored at last follow visit for primary outcome or death. Renal outcomes were analysed using Kaplan Meier survival plots of subgroups based on predicted risk (<16th percentile, 16-50th percentile, 50-84th percentile or >84th percentile). Results 121 patients were included in the analyses. 45 other patients were excluded based on exclusion criteria. 84 patients (69%) were males, mean age was 42±16 years, eGFR was 63±34ml/min and uPCR was 151±42mg/mmol. Mean follow up was 51.4±28 months. 87% were on RAS inhibition at or within 6 weeks of kidney biopsy diagnosis. During the follow up period 23 patients (19%) developed the primary outcome. Outcomes were significantly worse in patients with higher risk-prediction scores (Fig 1 log rank p<0.01). Conclusion This single centre study confirms that the International IgA Nephropathy Risk-Prediction Model for kidney outcomes can be a valuable tool for prognostication in Primary IgA Nephropathy in routine clinical practice.

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The reveal, reveal 2.0, compera and fphn risk scores in predciting the pah mortality: a single-centre study

European Heart Journal ◽

10.1093/ehjci/ehaa946.2308 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

S Tanyeri ◽

H.C Tokgoz ◽

B Keskin ◽

O.Y Akbal ◽

A Karagoz ◽

...

Keyword(s):

Risk Assessment ◽

Likelihood Ratio ◽

Right Atrial ◽

Walking Distance ◽

Risk Scores ◽

Ratio Test ◽

Single Centre ◽

Centre Study ◽

Single Centre Study

Abstract Aims Several risk prediction models have been developed for risk assessment at the time of diagnosis and during follow-up in patients (pts) with pulmonary arterial hypertension (PAH). In this single-centre study we aimed to compare baseline REVEAL, REVEAL 2.0, COMPERA and FPHN risk scores in predicting the mortality in pts with PAH. Methods Study group comprised of 504 pts (age 54.4±18.9 years, female 64.4%) with PAH out of the overall 852 pts with pulmonary hypertension enrolled fourteen year period. Subgroups of PAH were as follows; IPAH (39%), CHD-PAH (51%), CTD-PAH (7.7%) and other PAH (3.3%). Functional-class (FC), six-minute-walking-distance (6MWD), pericardial effusion (PE), right atrial area (RAA), tricuspid-annular-planary-systolic-excursion (TAPSE) and systolic annular velocity (St), Echo and Catheter pulmonary artery mean presures (PAMP) and N-terminal-pro brain natriuretic-peptide (NT-proBNP) measures were evaluated at baseline and periodical control examinations with 6-months apart. Baseline assessments for REVEAL, REVEAL 2.0, COMPERA and FPHN risk scores were performed in all pts. Results In baseline assessment mean FC and 6MWD were 3 (3–4 IQR), and 230±100 m, repectively. Mean PAMP was 51.5±26 mm Hg, and pulmonary vascular resistance was 8.8±6.5 Wood units. Mono, dual and triple combination therapies were noted in 42%, 40%, and 18% of pts. Median follow-up time was (1470 (275–4840 IQR)) and overall all-cause mortality was 32.1%. Using the Cox proportional hazard model, likelihood ratio (LR) of scores and p values were as follows; REVEAL: 95.09 (p<0.001), REVEAL-2: 122.16 (p<0.001), COMPERA: 22.73 (p<0.001) and FPHN: 1.63 (p=0.210). Adding the TAPSE on REVEAL 2.0 score did not increase the LR of REVEAL 2.0. When comparing the different combinations including REVEAL 2.0, with likelihood ratio test, the LR of REVEAL 2.0 plus TAPSE vs REVEAL 2.0 was 7.32 (p=0.12), Conclusions In this single-centre study, REVEAL 2.0 as compared to REVEAL, COMPERA and FPHN models provided the highest prediction for mortality, and adding the TAPSE on the REVEAL 2.0 scoring offered no additional benefit for risk assessment. Funding Acknowledgement Type of funding source: None

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