Details

Autor(en) / Beteiligte

• Chan, Chang-Yien
• Resontoc, Lourdes Paula
• Qader, Md Abdul
• Chan, Yiong-Huak
• Liu, Isaac Desheng
• Lau, Perry Yew-Weng
• Than, Mya
• Yeo, Wee-Song
• Loh, Alwin Hwai-Liang
• Tan, Puay-Hoon
• Wei, Changli
• Reiser, Jochen
• Biswas, Subhra K
• Ng, Kar-Hui
• Yap, Hui-Kim

Titel

MeSsAGe risk score: tool for renal biopsy decision in steroid-dependent nephrotic syndrome

Ist Teil von

• Pediatric research, 2019-03, Vol.85 (4), p.477-483

Ort / Verlag

United States: Nature Publishing Group

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• A lack of consensus exists as to the timing of kidney biopsy in children with steroid-dependent nephrotic syndrome (SDNS) where minimal change disease (MCD) predominates. This study aimed at examining the applicability of a biomarker-assisted risk score model to select SDNS patients at high risk of focal segmental glomerulosclerosis (FSGS) for biopsy. Fifty-five patients with SDNS and biopsy-proven MCD (n = 40) or FSGS (n = 15) were studied. A risk score model was developed with variables consisting of age, sex, eGFR, suPAR levels and percentage of CD8 memory T cells. Following multivariate regression analysis, total risk score was calculated as sum of the products of odds ratios and corresponding variables. Predictive cut-off point was determined using receiver operator characteristics (ROC) curve analysis. Plasma suPAR levels in FSGS patients were significantly higher, while percentage of CD45RO CD8 CD3 was significantly lower than in MCD patients and controls. ROC analysis suggests the risk score model with threshold score of 16.7 (AUC 0.84, 95% CI 0.72-0.96) was a good predictor of FSGS on biopsy. The 100% PPV cut-off was >24.0, while the 100% NPV was <13.3. A suPAR and CD8 memory T cell percentage-based risk score model was developed to stratify SDNS patients for biopsy and for predicting FSGS.