The Renal Activity Index for Lupus: Validation for Prediction of Kidney Inflammation in Adult Patients With Lupus Nephritis
Bibliographic record
Abstract
OBJECTIVE: To evaluate the ability of the Renal Activity Index for Lupus (RAIL) score, a urine biomarker-derived score, to capture and predict the course of active lupus nephritis (LN) in adult patients. METHODS: Available serial urine samples collected up to week 52 from a subset of adults with active biopsy-proven proliferative LN participating in the double-blind randomized ALLURE trial of abatacept (ClinicalTrials.gov: NCT01714817) were used to calculate RAIL scores from creatinine-adjusted urine biomarkers (neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule 1 [KIM-1], monocyte chemotactic protein 1 [MCP-1], adiponectin, hemopexin, ceruloplasmin). Discriminative performance of RAIL scores alone over time were compared with urine protein/creatinine ratio (UPCR), kidney function (estimated glomerular filtration rate [eGFR]), and mixed model analysis of RAIL score adjusted for baseline UPCR, eGFR, age, weight, sex, and race, with comparisons by renal response states including complete renal response (CRR), partial renal response but not CRR (PRR-only), and nonresponse (NR). RESULTS: The analysis included 240 patients who contributed 599 samples. At weeks 12/24/52, there were 44/22/15 patients with PRR-only, 27/33/18 with CRR, and 127/61/15 NR. RAIL scores, eGFR, and UPCR improved over time irrespective of abatacept use, but were significantly lower with CRR compared to NR. The eGFR alone had poor accuracy (area under the receiver-operating characteristic curve [AUC] < 0.51) to discriminate renal response. Only after correction of baseline UPCR and eGFR, the RAIL score had excellent accuracy to reflect CRR from other renal response states at the current (AUC = 0.83-0.84) and next visit (AUC = 0.84-0.85) and performed better than UPCR; without correction, UPCR and RAIL score had similarly good accuracy. CONCLUSION: RAIL scores identify active LN and longitudinally predict the course of adult LN. (ClinicalTrials.gov: NCT01714817).
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".