163. A RETROSPECTIVE COHORT STUDY TO INVESTIGATE SEX-SPECIFIC DIFFERENCES IN ANCA-ASSOCIATED GLOMERULONEPHRITIS OUTCOMES
Bibliographic record
Abstract
Background: There is a paucity of data surrounding sex-specific differences in ANCA-associated glomerulonephritis (ANCA-GN) outcomes. A recent study demonstrated that males have a significantly higher risk of progression to end-stage renal disease (ESRD), particularly in those with crescentic Berden class. We seek to validate this in a national Irish cohort and explore if treatment variances account for this difference. Methods: Patients recruited to the Irish Rare Kidney Disease (RKD) Registry and Biobank between 2012-2018, with biopsy proven pauci-immune glomerulonephritis and positive serology for anti-MPO or –PR3 antibodies were included. The occurrence of ESRD or death was obtained from registry follow-up. ESRD-free and patient survival was stratified by a variety of variables. Results: 190 patients were included, with a median observation period of 22.73 months (IQR 70.12). 113 (59.5%) were males, with a mean age of 65.5 years (SD 14.5). 107 (56.3%) were MPO positive, with a higher proportion of MPO-positivity in females (66.2% versus 49.6%, p-value = 0.03). 31 reached ESRD, while 10 died. There was no statistically significant difference in the incidence of ESRD or death, between sexes (OR 1.29 [CI 0.58 – 2.87], OR 0.43 [0.12 – 1.59] respectively), even when stratified by histological class. Conclusion: There was no sex-specific difference in the risk of ESRD or death in our national Irish cohort of ANCA-GN. This differs from the experience of other centres, and suggests we should explore this phenomenon on a wider scale to assess the true effect. Kaplan Meier survival curve demonstrating no statistical difference in the risk of ESRD between sexes in ANCA-GN (p = 0.37) Disclosures: This work was supported by a ‘JA Brian Keogh Award’, from the Meath Foundation, Ireland. Dr. Jennifer Scott is a Wellcome-HRB Irish Clinical Academic Training (ICAT) Fellow, and this work was performed within the Irish Clinical Academic Training (ICAT) Programme, supported by the Wellcome Trust and the Health Research Board (Grant Number 203930/B/16/Z), the Health Service Executive, National Doctors Training and Planning and the Health and Social Care, Research and Development Division, Northern Ireland.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".