PREDICTIVE VALUE OF CHRONIC HISTOLOGIC CHANGES IN LUPUS NEPHRITIS
Notice bibliographique
Résumé
O041 / #709 Topic:AS15 - Lupus Nephritis-Clinical ABSTRACT CONCURRENT SESSION 06: LUPUS NEPHRITIS – CLINICAL OUTCOMES, PREDICTION AND THERAPY 23-05-2025 1:40 PM - 2:40 PM Background/Purpose The Mayo Clinic Chronicity Score (MCCS) is a tool to assess the chronicity of renal histology in glomerulopathies. This tool includes arteriosclerosis (AE), a chronic vascular lesion, and has not been evaluated in lupus nephritis (LN). Our objective was to evaluate the predictive value of the individual components of the International Society of Nephrology/Renal Pathology Society and MCCS in LN. Methods LN patients from Mayo Clinic between 1992 and 2023 were included. The earliest kidney biopsy was index date. Follow-up was until July 2023, death or loss follow-up. Biopsy reports were reviewed by a nephropathologist and chronic lesions reclassified (glomerulosclerosis [GS], interstitial fibrosis [IF], tubular atrophy [TA], arteriosclerosis [AE], and fibrous crescents [FC]). The outcomes were proteinuria <500 mg/day and complete renal response (CRR) within 1-year, end-stage kidney disease (ESKD), and death. We used stratified multivariable proportional hazards regression adjusted for sex and age. P-values <0.05 were statistically significant. Results We included 307 patients (median age, 34 years; 75% female; median follow-up, 11 years). The majority had class III, IV. FC were in 4.9%, AE in 12%. Table shows hazard ratios of proteinuria<500 mg/day, CRR, ESRD, and death for different variables of interest. At one year, 47.5% had proteinuria <500 mg/day and 43.4% CRR. Those with grade 2-3 of GS (HR 0.21 [0.09, 0.48]) and grade 2-3 IFTA (HR 0.14 [0.05, 0.39]) were less likely to achieve proteinuria <500 mg/day. Grade 2-3 of GS (HR 0.19 [0.08, 0.48]) and grade 2-3 IFTA (HR 0.16 [0.06, 0.44]) were also less likely to achieve CRR. (Figure 1) shows increasing grades of GS is associated with a lower chance of CRR. Similarly, AE (HR 0.44 [0.21, 0.91], for proteinuria <500 mg/day, HR 0.37 [0.16, 0.84], for CRR) was associated with a reduced likelihood of achieving the outcomes. During follow-up, 33 patients died, and 60 developed ESKD. No variables were associated with mortality. Grade 2-3 GS (HR 9.28 [4.91, 17.54], grade 2-3 IFTA (HR 20.10 [10.08, 40.08]), and the presence of AE (HR 3.56 [1.87, 6.78]) were associated with an increased ESKD. (Figure 2) shows increasing grades of GS is associated with a greater chance of ESKD. Table. Hazard ratios of proteinuria <500 mg/day, CRR, ESKD, and death for variables. Figure 1: Kaplan Meier curve for complete renal response (CRR) for glomerulosclerosis (GS) score. Black line: GS grade 0, red: GS grade 1, green: GS grades 2-3. Increasing GS is associated with a lower chance of CRR. Figure 2: Kaplan Meier curve for end stage kidney disease (ESKD) for glomerulosclerosis (GS) score. Black line: GS grade 0, red: GS grade 1, green: GS grades 2-3. Increasing GS is associated with greater hazard of ESKD Conclusions GS, IFTA, AE are independently associated with outcomes in LN. FC is rare finding. The MCCS included all the chronic histologic elements associated with outcomes in LN.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».