title: A predictive model of progressive chronic kidney disease in idiopathic nephrotic syndrome.
abstract: BACKGROUND
  There are limited data on the risk factors for chronic kidney disease (CKD) in children with idiopathic nephrotic syndrome (INS). This retrospective cohort study aimed to develop a predictive model for CKD progression in children with INS.
  
  
  METHODS
  Between 1970 and 2012, a total of 294 patients with INS were followed up. The primary outcome was progression to CKD stage 3 or higher. A predictive model was developed using a Cox proportional hazards model. A score was calculated using b-coefficients and summing up points assigned to each significant variable. Prognostic score was grouped into categories: low risk, medium risk, and high risk.
  
  
  RESULTS
  Median follow-up was 6.9 years. Median renal survival was 26.1 years and probability of CKD stage 3 or higher was 8% in 10 years. Multivariate analysis showed that the most accurate model included initial age, hematuria, and steroid resistance. Accuracy was high with a c-statistic of 0.95 (95% confidence interval [CI] 0.91-0.99), 0.92 (95% CI 0.88-0.96), and 0.92 (95% CI 0.87-0.97) at 2, 5, and 10 years of follow-up respectively. By survival analysis, 10-year renal survival was 100% for the low-risk and 95% for the medium-risk group, while 40% of high-risk patients would exhibit CKD stage 3 or higher (P < 0.001).
  
  
  CONCLUSIONS
  Our predictive model of CKD may contribute to the early identification of a subgroup of INS patients at a high risk of renal dysfunction.
authors.affiliation: Pediatric Nephrology Unit, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Ana Carmen Quaresma
authors.initials: AC
authors.lastname: Mendonça
authors.affiliation: Pediatric Nephrology Unit, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Eduardo Araújo
authors.initials: EA
authors.lastname: Oliveira
authors.affiliation: Pediatric Nephrology Unit, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Brunna Pinto
authors.initials: BP
authors.lastname: Fróes
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Lauro Damasceno Carvalho
authors.initials: LD
authors.lastname: Faria
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Juliana Silva
authors.initials: JS
authors.lastname: Pinto
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Maira Melo Ibrahim
authors.initials: MM
authors.lastname: Nogueira
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Gabriella Oliveira
authors.initials: GO
authors.lastname: Lima
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Priscila Isa
authors.initials: PI
authors.lastname: Resende
authors.affiliation: Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Natália Silva
authors.initials: NS
authors.lastname: Assis
authors.affiliation: Pediatric Nephrology Unit, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões E Silva
authors.affiliation: Pediatric Nephrology Unit, Federal University of Minas Gerais, Belo Horizonte, Brazil. svbpinheiro@gmail.com.
authors.forename: Sérgio Veloso Brant
authors.initials: SV
authors.lastname: Pinheiro
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009404:Nephrotic Syndrome / Q000150:complications*; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Chronic kidney disease; End-stage renal disease; Focal segmental glomerulosclerosis; Minimal change nephrotic syndrome; Nephrotic syndrome; Predictive model