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Mô hình dự đoán tiến triển bệnh thận mãn tính ở hội chứng thận hư vô căn
Tóm tắt
Có rất ít dữ liệu về các yếu tố nguy cơ đối với bệnh thận mãn tính (CKD) ở trẻ em bị hội chứng thận hư vô căn (INS). Nghiên cứu đoàn hệ hồi cứu này nhằm phát triển một mô hình dự đoán cho tiến triển CKD ở trẻ em bị INS. Từ năm 1970 đến năm 2012, tổng cộng 294 bệnh nhân bị INS đã được theo dõi. Kết quả chính là sự tiến triển đến giai đoạn CKD 3 hoặc cao hơn. Một mô hình dự đoán đã được xây dựng sử dụng mô hình nguy cơ tỷ lệ Cox. Một điểm số được tính toán bằng cách sử dụng các hệ số b và cộng tổng các điểm được chỉ định cho từng biến có ý nghĩa. Điểm số tiên đoán được phân nhóm thành các hạng: nguy cơ thấp, nguy cơ trung bình và nguy cơ cao. Thời gian theo dõi trung vị là 6,9 năm. Thời gian sống thận trung vị là 26,1 năm và xác suất mắc CKD giai đoạn 3 hoặc cao hơn là 8% trong 10 năm. Phân tích đa biến cho thấy mô hình chính xác nhất bao gồm tuổi ban đầu, tiểu máu và kháng steroid. Độ chính xác cao với chỉ số c-statistic là 0,95 (khoảng tin cậy [CI] 95% 0,91–0,99), 0,92 (CI 95% 0,88–0,96), và 0,92 (CI 95% 0,87–0,97) ở 2, 5 và 10 năm theo dõi tương ứng. Theo phân tích sống còn, tỷ lệ sống thận 10 năm là 100% đối với nhóm nguy cơ thấp và 95% đối với nhóm nguy cơ trung bình, trong khi 40% bệnh nhân có nguy cơ cao sẽ biểu hiện CKD giai đoạn 3 hoặc cao hơn (P < 0,001). Mô hình dự đoán CKD của chúng tôi có thể góp phần vào việc xác định sớm một nhóm bệnh nhân INS có nguy cơ cao mắc rối loạn chức năng thận.
Từ khóa
#bệnh thận mãn tính #hội chứng thận hư vô căn #mô hình dự đoán #yếu tố nguy cơ #tiểu máu #kháng steroidTài liệu tham khảo
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