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Abstract: PO1876

Prediction of Morphological Lesions Using Various Glomerular Filtration Rate Equations in Patients with Primary Glomerulonephritis

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Saganova, Elena, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
  • Galkina, Olga, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
  • Sipovskii, Vasiliy, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
  • Kayukov, Ivan, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
  • Smirnov, Alexey, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
Background

Glomerular filtration rate (GFR) is generally accepted best overall index of kidney function. However, it remains controversial to use GFR as a marker of morphological lesions. Aim. To assess GFR equations as a predictor of chronic morphological lesions in patients with glomerulonephritis (GN).

Methods

100 patients [48 female, age Me 39 (27; 54) years] with biopsy proven primary GN were included in the study (9%–minimal change disease, 28%–focal segmental glomerulosclerosis, 26%–membranous nephropathy, 37%–IgA-nephropathy). Serum creatinine was measured by enzymatic, serum cystatin C - immunoturbidimetric methods. GFR was estimated using creatinine clearance (CCr), MDRD, CKD-EPICr, CKD-EPICysC, CKD-EPICrCysC, full age spectrum (FASsCr) equations. Glomerulosclerosis (GS) was assessed quantitatively, tubulo-interstitial fibrosis (TIF), tubular atrophy (TA) - semi-quantitatively (0-lesions absent; 1-mild focal lesions; 2-moderate lesions; 3-diffuse lesions). All patients were separated consistently in two groups according to the degree of each morphological lesion: “mild” (GS<25% or TIF/TA=0-1), “severe” (GS≥25% or TIF/TA=2-3).

Results

Independently of estimating equation, GFR positively correlated (p<0,001) with GS, TIF, TA and was higher in patients with “mild” GS, TIF and TA (p<0,001). Based on the results of ROC-analysis patients were separated (p<0.001) in two groups using all equations according to the degree of morphological lesions (“mild” or “severe” GS, TIF and TA). Using comparison of AUC we found the significant difference between CCr and CKD-EPICr, CKD-EPICysC, CKD-EPICrCysC, between MDRD and CKD-EPICr, CKD-EPICrCysC equations in prediction of TIF, between CKD-EPICrCysC and FASsCr - in prediction of GS and no difference for all equations in prediction of TA (Fig. 1).

Conclusion

Independently of estimating equation, GFR is a good marker of morphological lesions in patients with primary GN. Our data shows that CKD-EPI equations, especially CKD-EPICrCysC, provide the highest diagnostic value in prediction GS and TIF.

Fig. 1. ROC-curves of GFR equations for: A – GS; B – TIF; C – TA

Funding

  • Government Support - Non-U.S.