Abstract: FR-PO0949
Comparative Performance of Kidney Risk Scores for One-Year Kidney Outcomes in Pediatric Patients with Crescentic Glomerulonephritis
Session Information
- Pediatric Nephrology: Genetic Diseases, Development, Neonatal Nephrology, Glomerular Diseases, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Stojkic, Ivana, Nationwide Children's Hospital, Columbus, Ohio, United States
- Wenderfer, Scott E., The University of British Columbia, Vancouver, British Columbia, Canada
- Gaut, Joseph, Washington University in St Louis, St. Louis, Missouri, United States
- Biederman, Laura, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Smoyer, William E., Nationwide Children's Hospital, Columbus, Ohio, United States
- Hidalgo, Guillermo, Hackensack Meridian Health Inc, Edison, New Jersey, United States
Background
Assessing the trajectory toward kidney failure in crescentic glomerulonephritis (CrGN) is a critical clinical goal. While pediatric CrGN typically presents with more cellular crescents and less chronic damage than adult cases, existing scoring systems have not been extensively validated in children. The objective was to compare the accuracy of four existing scoring systems for predicting 1-year kidney survival in pediatric CrGN and to determine the clinical utility of the new AKRiS scoring system in this population.
Methods
This retrospective cohort study utilized data from the Pediatric Nephrology Research Consortium (PNRC). Patients with biopsy-proven CrGN and ≥ 12 months of follow-up were included. The primary outcome was kidney failure at 12 months. We evaluated four scoring systems: Berden classification, Percentage of ANCA Crescentic Score (PACS), ANCA Renal Risk Score (ARRS), and the AKRiS. The predictive accuracy of each scoring system was assessed via Harrell’s C-index from time-to-event models. Kidney failure was defined as the event for survival analysis.
Results
This retrospective cohort study utilized data from the Pediatric Nephrology Research Consortium (PNRC). Patients with biopsy-proven CrGN and ≥ 12 months of follow-up were included. The primary outcome was kidney failure at 12 months. We evaluated four scoring systems: Berden classification, Percentage of ANCA Crescentic Score (PACS), ANCA Renal Risk Score (ARRS), and the AKRiS. The predictive accuracy of each scoring system was assessed via Harrell’s C-index from time-to-event models. Kidney failure was defined as the event for survival analysis.
Conclusion
While AKRiS improves risk prediction in adult ANCA-GN it offered no distinct advantage over existing systems in this pediatric cohort. This may reflect the greater prognostic contribution of eGFR in children, where it accounts for body size and composition better than serum creatinine alone. The ARRS demonstrated robust performance across ANCA and non-ANCA etiologies, supporting its utility for risk stratification in pediatric crescentic glomerulonephritis.