A nomogram for predicting GFR decline in children with Henoch-Schönlein purpura nephritis

LI Yan; YUAN Ting-ting; ZHOU Su-qin; WANG Qing-qing; LU Qian; YANG Huan-dan; SHANG Qiao-yu; ZHANG Rui-Feng

doi:10.19538/j.ek2025050612

Abstract：Objective To investigate the risk factors for renal damage in children with Henoch-Schönlein purpura(HSP),and to develop a nomogram for predicting decreased glomerular filtration rate(GFR)in children with Henoch-Schonlein purpura nephritis(HSPN).Methods 116 children with HSPN confirmed by renal biopsy from July 2021 to June 2024 were enrolled.The demographic characteristics,clinical and renal pathological characteristics of children with HSPN were utilized to develop a nomogram model for predicting the progression of HSPN.Ten-fold cross-validation was used to select the optimal harmonic coefficient λ in the model.The discrimination and accuracy of the prediction model were evaluated based on the receiver operating characteristic curve(ROC)and calibration curve,respectively,and a nomogram was drawn.Results The results showed that serum creatinine and renal pathology were independent risk factors affecting the progression of HSPN(P＜0.05).Two variables affecting the prognosis of children with HSPN were selected through the LASSO regression method,and a nomogram was built based on these variables.The predictive model yielded an AUC of 0.957(95％CI 0.925-0.990),The calibration curve showed that the risk factors for HSPN progression predicted by the nomogram were in good agreement with the actual results.The decision curve analysis showed that the nomogram model could obtain clinical benefits within a large threshold range(0-90％).It has good practicability.Conclusion In this study,Based on the two independent risk factors of serum creatinine and renal pathology,a nomogram model was established for the first time in predicting the risk of decreased GFR in children with HSPN,which has great value in predicting the decreased renal function in children with HSPN.