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Abstract: FR-PO0870

Unsupervised Clustering Identifies High-Risk Phenotypic Subgroup in Patients with Crescentic Glomerulonephritis

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Tang, Yaoyao, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Xiang, Wang, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Xia, Xi, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Chen, Wei, Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
Background

The current classification of crescentic glomerulonephritis (cGN) primarily focuses on renal outcomes, its ability to predict overall patient survival remains controversial. This study aims to develop a risk stratification system for overall survival and validate a renal risk score for predicting end-stage renal disease (ESRD) in cGN.

Methods

A retrospective analysis was conducted on 224 cGN patients from the First Affiliated Hospital of Sun-Yat Sen University. The primary outcome was all-cause mortality and the secondary outcome was ESRD. Unsupervised clustering analysis, Principal component analysis were used to identify distinct patient groups.

Results

The new K-means clustering revealed high-risk (n=142) and low-risk groups (n=82), with significant differences in patient survival outcomes (63.1% vs. 89.6%, P=0.004). Moreover, multivariate Cox regression indicated that the high-risk group independently predicted all-cause mortality (HR=3.28, P=0.002). We found that the crescentic glomerulonephritis kidney risk score (cGN-KS) consisting of serum creatinine levels, the percentage of normal glomeruli, and tubular atrophy/interstitial fibrosis independently predicted ESRD (HR=1.10, P<0.001) in cGN.

Conclusion

Our study identifies two survival risk groups and develops a renal risk score in cGN patients, providing a comprehensive risk stratification to facilitate the management of cGN.

Funding

  • Government Support – Non-U.S.

Digital Object Identifier (DOI)