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Dividing CKD stage 3 into G3a and G3b could better predict the prognosis of IgA nephropathy.

Abstract Chronic kidney disease (CKD) stage 3 was divided into stage G3a and stage G3b in the 2013 Kidney Disease Improving Global Outcomes guidelines. Whether it is appropriate to regard 45 mL/min/per 1.73 m2 as the threshold value of G3a/G3b staging and whether dividing CKD stage 3 into G3a/G3b plays a useful role in assessing the prognosis of patients with IgA nephropathy (IgAN) remain unknown. Three hundred and ninety patients from the First Affiliated Hospital of Zhengzhou University and Peking University First Hospital diagnosed with IgAN in CKD stage 3 were enrolled and successfully followed up. Cox proportional hazards model was used to analyze hazard ratios of reaching the composite endpoints (doubling of serum creatinine, end-stage renal disease: estimated glomerular filtration rate (eGFR) <15 ml/min/per 1.73 m2 or renal replacement therapy, or death) for patients with different eGFR and risk factors affecting composite endpoints. The Kaplan-Meier method was used to calculate the cumulative renal survival rate of patients. When eGFR was lower than 45 ml/min/per 1.73 m2, the hazard ratio increased sharply for patients in CKD stage 3 who reached the composite endpoints. Renal injury and prognosis were significantly different between patients in the G3a and G3b groups. Stage G3b was a major risk factor affecting prognosis. A threshold value of 45 ml/min/per 1.73 m2 appears appropriate to assess the prognosis of IgAN patients with CKD stage 3. Dividing IgAN patients with CKD stage 3 into G3a and G3b is very useful to help understand disease conditions and for predicting the risk for disease progression.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 28414748
OWN - NLM
STAT- In-Process
DA  - 20170417
LR  - 20170417
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - Dividing CKD stage 3 into G3a and G3b could better predict the prognosis of IgA
      nephropathy.
PG  - e0175828
LID - 10.1371/journal.pone.0175828 [doi]
AB  - Chronic kidney disease (CKD) stage 3 was divided into stage G3a and stage G3b in 
      the 2013 Kidney Disease Improving Global Outcomes guidelines. Whether it is
      appropriate to regard 45 mL/min/per 1.73 m2 as the threshold value of G3a/G3b
      staging and whether dividing CKD stage 3 into G3a/G3b plays a useful role in
      assessing the prognosis of patients with IgA nephropathy (IgAN) remain unknown.
      Three hundred and ninety patients from the First Affiliated Hospital of Zhengzhou
      University and Peking University First Hospital diagnosed with IgAN in CKD stage 
      3 were enrolled and successfully followed up. Cox proportional hazards model was 
      used to analyze hazard ratios of reaching the composite endpoints (doubling of
      serum creatinine, end-stage renal disease: estimated glomerular filtration rate
      (eGFR) &lt;15 ml/min/per 1.73 m2 or renal replacement therapy, or death) for
      patients with different eGFR and risk factors affecting composite endpoints. The 
      Kaplan-Meier method was used to calculate the cumulative renal survival rate of
      patients. When eGFR was lower than 45 ml/min/per 1.73 m2, the hazard ratio
      increased sharply for patients in CKD stage 3 who reached the composite
      endpoints. Renal injury and prognosis were significantly different between
      patients in the G3a and G3b groups. Stage G3b was a major risk factor affecting
      prognosis. A threshold value of 45 ml/min/per 1.73 m2 appears appropriate to
      assess the prognosis of IgAN patients with CKD stage 3. Dividing IgAN patients
      with CKD stage 3 into G3a and G3b is very useful to help understand disease
      conditions and for predicting the risk for disease progression.
FAU - Zhang, Jun-Jun
AU  - Zhang JJ
AUID- ORCID: http://orcid.org/0000-0002-6801-2900
AD  - Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, Henan, PR China.
AD  - Research Institute of Nephropathy, Zhengzhou University, Zhengzhou, Henan, China.
FAU - Yu, Gui-Zhen
AU  - Yu GZ
AD  - Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, Henan, PR China.
AD  - Research Institute of Nephropathy, Zhengzhou University, Zhengzhou, Henan, China.
FAU - Zheng, Zhao-Hui
AU  - Zheng ZH
AD  - Research Institute of Nephropathy, Zhengzhou University, Zhengzhou, Henan, China.
AD  - Department of Rheumatism Immunity, The First Affiliated Hospital of Zhengzhou
      University, Zhengzhou, Henan, China.
FAU - Liu, Ya-Fei
AU  - Liu YF
AD  - Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, Henan, PR China.
AD  - Research Institute of Nephropathy, Zhengzhou University, Zhengzhou, Henan, China.
FAU - Du, Yang-Yang
AU  - Du YY
AD  - Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, Henan, PR China.
AD  - Research Institute of Nephropathy, Zhengzhou University, Zhengzhou, Henan, China.
FAU - Quan, Song-Xia
AU  - Quan SX
AD  - Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, Henan, PR China.
AD  - Research Institute of Nephropathy, Zhengzhou University, Zhengzhou, Henan, China.
FAU - Liu, Yu-Jie
AU  - Liu YJ
AD  - Department of Nephrology and Rheumatology, Children's Hospital of Zhengzhou City,
      Zhengzhou, Henan, China.
FAU - Lv, Ji-Cheng
AU  - Lv JC
AD  - Renal Division, Peking University First Hospital, Beijing, China.
FAU - Zhang, Hong
AU  - Zhang H
AD  - Renal Division, Peking University First Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20170417
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/04/18 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/04/18 06:00
PHST- 2017/01/04 [received]
PHST- 2017/04/01 [accepted]
AID - 10.1371/journal.pone.0175828 [doi]
AID - PONE-D-16-48007 [pii]
PST - epublish
SO  - PLoS One. 2017 Apr 17;12(4):e0175828. doi: 10.1371/journal.pone.0175828.
      eCollection 2017.