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Kidney Week

Abstract: FR-PO890

Visualization of Remission Status in IgA Nephropathy Using the Multistate Model

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Matsuzaki, Keiichi, Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
  • Suzuki, Hitoshi, Department of Nephrology, Juntendo University Urayasu Hospital, Urayasu, Japan
  • Sozu, Takashi, Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
  • Hirano, Keita, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
  • Yasuda, Takashi, Akihabaraizumi Clinic, Tokyo, Japan
  • Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
  • Suzuki, Yusuke, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
Background

Transition of urinary abnormalities during the clinical course of IgA nephropathy (IgAN) is associated with renal prognosis. We had proposed new criteria for clinical remission in patients with IgA nephropathy (Clin Exp Nephrol, 2014), and reported the association for renal prognosis (Clin Exp Nephrol, 2021). Multi-state model enables the visual interpretation of the transition to each state over time from the multistate transition probability diagram. The aim of study is to estimate the transition probabilities of remission status both hematuria and proteinuria.

Methods

We extracted the 904 Japanese adults patients with biopsy-proven IgAN (male 50.1%, median age 35.0) from the multicenter cohort study which was previously reported (JAMA Netw Open. 2019). Baseline characteristics were evaluated at biopsy, and clinical data including serum creatinine, urinary findings, treatment options were collected at every visit. Multistate-model during 5 years after biopsy was defined using the proposed remission criteria, for patients with hematuria or patients with proteinuria, respectively. Stacked prediction probabilities of remission was calculated at 5 years after renal biopsy.

Results

824 patients were included in the analysis for patients with hematuria, and 748 patients were included in the analysis for patients with proteinuria. Tonsillectomy was performed for 198 patients with hematuria, and for 179 patients with proteinuria. While the entire cohorts, the stacked prediction probabilities for remission of hematuria was 0.32 and of proteinuria was 0.30. Figure shows that the stacked transition probabilities of remission status by urinary abnormalities and tonsillectomy. In both criteria of hematuria and proteinuria, tonsillectomy derived higher probabilities in remission than without tonsillectomy (hematuria: 0.50 vs 0.26, proteinuria: 0.42 vs 0.26).

Conclusion

In present study, we proposed visualization of the remission status. Tonsillectomy leads to higher remission rate both hematuria and proteinuria.