Background: IgA nephropathy (IgAN) is a cause of chronic kidney disease (CKD). Tubular atrophy/interstitial fibrosis is associated with IgAN prognosis. However, simple tools for predicting pathological lesions of IgAN remain limited. Our objective was to develop a tool for evaluating tubular atrophy/interstitial fibrosis in patients with IgAN./nMethods: In this cross-sectional study, 410 biopsy-verified IgAN patients were included. The factors associated with the incident interstitial fibrosis or tubular atrophy in IgAN were confirmed by using logistic regression analysis. A nomogram was developed using logistic regression coefficients to evaluate tubular atrophy or interstitial fibrosis. Receiver operating characteristic curves (ROC) and calibration curves were used to determine the discriminative ability and predictive accuracy of the nomogram./nResults: In this study, the IgAN patients with tubular atrophy or interstitial fibrosis were older and had a higher percentage of males, hypertension and urinary protein excretion (UPE), with high levels of serum cystatin C, serum creatinine, high-sensitivity C-reactive protein and serum C4. The eGFRcr-cys equation calculated using serum creatinine, cystatin C and UPE were considered independent influencing factors of tubular atrophy or interstitial fibrosis in patients with IgAN. Furthermore, the nomogram demonstrated good discrimination (AUC: 0.87, 95% CI 0.81 to 0.93) and calibration in the validation cohort./nConclusion: The eGFRcr-cys and UPE are associated with tubular atrophy or interstitial fibrosis in patients with IgAN. Diagnostic nomogram can predict tubular atrophy or interstitial fibrosis in IgAN.

中文翻译：

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开发和验证诊断列线图以评估 IgA 肾病的肾小管萎缩/间质纤维化

背景： IgA 肾病（IgAN）是慢性肾脏病（CKD）的一个原因。肾小管萎缩/间质纤维化与 IgAN 预后相关。然而，预测 IgAN 病理病变的简单工具仍然有限。我们的目标是开发一种工具来评估 IgAN 患者的肾小管萎缩/间质纤维化。/n方法：在这项横断面研究中，纳入了 410 名经活检证实的 IgAN 患者。通过逻辑回归分析证实了与 IgAN 中发生间质纤维化或肾小管萎缩相关的因素。使用逻辑回归系数开发列线图来评估肾小管萎缩或间质纤维化。使用受试者工作特征曲线（ROC）和校准曲线来确定列线图的判别能力和预测准确性。/n结果：本研究中，出现肾小管萎缩或间质纤维化的 IgAN 患者年龄较大，且男性比例较高、高血压和尿蛋白排泄（UPE），血清胱抑素C、血清肌酐、超敏C反应蛋白和血清C4水平较高。利用血清肌酐、胱抑素C和UPE计算的eGFRcr-cys方程被认为是IgAN患者肾小管萎缩或间质纤维化的独立影响因素。此外，列线图在验证队列中表现出良好的区分度（AUC：0.87，95% CI 0.81 至 0.93）和校准。/n结论： eGFRcr-cys 和 UPE 与 IgAN 患者的肾小管萎缩或间质纤维化相关。诊断列线图可以预测 IgAN 中的肾小管萎缩或间质纤维化。