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Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations.

Publication ,  Journal Article
Lemley, KV; Bagnasco, SM; Nast, CC; Barisoni, L; Conway, CM; Hewitt, SM; Song, PXK
Published in: PLoS One
2016

OBJECTIVE: Most predictive models of kidney disease progression have not incorporated structural data. If structural variables have been used in models, they have generally been only semi-quantitative. METHODS: We examined the predictive utility of quantitative structural parameters measured on the digital images of baseline kidney biopsies from the NEPTUNE study of primary proteinuric glomerulopathies. These variables were included in longitudinal statistical models predicting the change in estimated glomerular filtration rate (eGFR) over up to 55 months of follow-up. RESULTS: The participants were fifty-six pediatric and adult subjects from the NEPTUNE longitudinal cohort study who had measurements made on their digital biopsy images; 25% were African-American, 70% were male and 39% were children; 25 had focal segmental glomerular sclerosis, 19 had minimal change disease, and 12 had membranous nephropathy. We considered four different sets of candidate predictors, each including four quantitative structural variables (for example, mean glomerular tuft area, cortical density of patent glomeruli and two of the principal components from the correlation matrix of six fractional cortical areas-interstitium, atrophic tubule, intact tubule, blood vessel, sclerotic glomerulus, and patent glomerulus) along with 13 potentially confounding demographic and clinical variables (such as race, age, diagnosis, and baseline eGFR, quantitative proteinuria and BMI). We used longitudinal linear models based on these 17 variables to predict the change in eGFR over up to 55 months. All 4 models had a leave-one-out cross-validated R2 of about 62%. CONCLUSIONS: Several combinations of quantitative structural variables were significantly and strongly associated with changes in eGFR. The structural variables were generally stronger than any of the confounding variables, other than baseline eGFR. Our findings suggest that quantitative assessment of diagnostic renal biopsies may play a role in estimating the baseline risk of succeeding loss of renal function in future clinical studies, and possibly in clinical practice.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2016

Volume

11

Issue

6

Start / End Page

e0157148

Location

United States

Related Subject Headings

  • Statistics as Topic
  • Proteinuria
  • Prognosis
  • Organ Size
  • Longitudinal Studies
  • Linear Models
  • Kidney Glomerulus
  • Kidney Diseases
  • Kidney
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Lemley, K. V., Bagnasco, S. M., Nast, C. C., Barisoni, L., Conway, C. M., Hewitt, S. M., & Song, P. X. K. (2016). Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations. PLoS One, 11(6), e0157148. https://doi.org/10.1371/journal.pone.0157148
Lemley, Kevin V., Serena M. Bagnasco, Cynthia C. Nast, Laura Barisoni, Catherine M. Conway, Stephen M. Hewitt, and Peter X. K. Song. “Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations.PLoS One 11, no. 6 (2016): e0157148. https://doi.org/10.1371/journal.pone.0157148.
Lemley KV, Bagnasco SM, Nast CC, Barisoni L, Conway CM, Hewitt SM, et al. Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations. PLoS One. 2016;11(6):e0157148.
Lemley, Kevin V., et al. “Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations.PLoS One, vol. 11, no. 6, 2016, p. e0157148. Pubmed, doi:10.1371/journal.pone.0157148.
Lemley KV, Bagnasco SM, Nast CC, Barisoni L, Conway CM, Hewitt SM, Song PXK. Morphometry Predicts Early GFR Change in Primary Proteinuric Glomerulopathies: A Longitudinal Cohort Study Using Generalized Estimating Equations. PLoS One. 2016;11(6):e0157148.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2016

Volume

11

Issue

6

Start / End Page

e0157148

Location

United States

Related Subject Headings

  • Statistics as Topic
  • Proteinuria
  • Prognosis
  • Organ Size
  • Longitudinal Studies
  • Linear Models
  • Kidney Glomerulus
  • Kidney Diseases
  • Kidney
  • Humans