Prediction model for renal outcomes in Latin American Mestizo patients with pure proliferative lupus nephritis

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dc.catalogadordfo
dc.contributor.authorVillalobos Navarro, Arturo
dc.contributor.authorXipell, Marc
dc.contributor.authorGarduño Hernández, Estefanía
dc.contributor.authorValjalo, Ricardo
dc.contributor.authorContreras, Francisco
dc.contributor.authorRuiz de Arechavaleta, Andrea
dc.contributor.authorSegura, Paula
dc.contributor.authorMiranda, Daniel
dc.contributor.authorAvila Jimenéz, Eduardo Rodolfo
dc.contributor.authorHidalgo, María José
dc.contributor.authorDiaz Garcia, Juan Daniel
dc.contributor.authorPazos Pérez, Fabiola
dc.contributor.authorValderrama Ávila, Diana
dc.contributor.authorGil Arredondo, María Inés
dc.contributor.authorGuillén, Elena
dc.contributor.authorCervera, Ricard
dc.contributor.authorEspinosa, Gerard
dc.contributor.authorPereira, Arturo
dc.contributor.authorBlasco, Miquel
dc.contributor.authorQuintana, Luis F
dc.date.accessioned2025-10-16T13:09:20Z
dc.date.available2025-10-16T13:09:20Z
dc.date.issued2025
dc.description.abstractObjective: Lupus nephritis (LN) is associated with a poorer prognosis in Latin American populations. However, the contributing risk factors contributing to this remain to be fully elucidated. This study aimed to develop a prognostic model for poor renal outcomes in patients of mestizo descent. Methods: We conducted a multicentre, retrospective analysis including 290 adult mestizo patients with incident, biopsy-proven pure proliferative LN (International Society of Nephrology/Renal Pathology Society (ISN/RPS) class III or IV) from nine Chilean hospitals. Clinical, biological and histological variables were assessed. The primary outcome was a composite of stage IV/V chronic kidney disease, dialysis or death. Predictive variables were selected using multivariable Cox regression, and prognostic scores were derived accordingly. Internal validation was performed via bootstrapping. External validation included 93 Mexican patients, with model performance assessed using Harrel’s concordance index. Results: Two baseline factors were independently associated with poor renal outcome: estimated glomerular filtration rate <30mL/min/m2 (HR 3.82, 95%CI 2.15 to 6.78; p<0.001) and histological chronicity index >2 (HR 2.01, 95%CI 1.18 to 3.43; p=0.01). Patients were stratified into three risk categories according to the presence of none (low risk), one (intermediate risk) or both (high risk) of these factors. The likelihood of the primary outcome increased progressively across these groups: high versus intermediate risk (HR 3.22, 95%CI 1.64 to 6.34; p=0.001), and intermediate versus low risk group (HR 2.41, 95%CI 1.35 to 4.30; p=0.003). The three-tier model was replicated in the validation cohort with a concordance index of 79% (95% CI 71% to 87%; p<0.001) between predicted and observed results. Conclusions: Based on two readily available features at the time of diagnosis, the proposed model effectively stratifies Latin American mestizo patients with pure proliferative LN (ISN/RPS class III or IV) into three risk categories for poor renal outcome. This tool may support improved risk-based management in this high-risk population.
dc.fechaingreso.objetodigital2025-10-16
dc.format.extent9 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1136/lupus-2025-001649
dc.identifier.urihttps://doi.org/10.1136/lupus-2025-001649
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/106225
dc.information.autorucEscuela de Medicina; Avila Jimenez Eduardo Rodolfo; S/I; 208077
dc.issue.numero12
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaLupus Science & Medicine
dc.rightsacceso abierto
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePrediction model for renal outcomes in Latin American Mestizo patients with pure proliferative lupus nephritis
dc.typeartículo
sipa.codpersvinculados208077
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