Development and validation of a predictive model for rapid renal function decline in early IgA nephropathy: a multicenter retrospective study

The study focused on developing a predictive model to identify patients with early-stage IgA nephropathy at high risk of rapid renal function decline. A total of 483 patients with confirmed diagnosis were divided into a training cohort (338 patients) and a validation cohort (145 patients). Rapid renal function decline was defined as a decrease in filtration rate of at least 25 percent or progression to end-stage renal disease. In the training cohort, 83 patients (24.6 percent) reached the endpoint with a median time to event of 13.6 months. The analysis identified several risk factors including Lambda light chain deposition in renal tissue, higher systolic blood pressure, and elevated chloride and blood urea nitrogen levels. The developed nomogram demonstrated good discriminatory ability with a one-year AUC value of 0.86 in the training cohort and 0.80 in the validation cohort. The model may help with early risk stratification and individualized patient management.