Key result
A nomogram integrating shear wave elastography, hypertension, and eGFR showed favorable discrimination for moderate-severe renal impairment in training (AUC 0.94) and validation (AUC 0.84) cohorts.
Why the study?
Non-invasive evaluation of renal fibrosis remains challenging in chronic kidney disease.
Does a nomogram based on shear wave elastography and clinical features accurately assess the severity of renal fibrosis in patients with chronic kidney disease?
Observational (n=162)
Randomly divided into training and validation cohorts
Does a nomogram based on shear wave elastography and clinical features accurately assess the severity of renal fibrosis in patients with chronic kidney disease?
Effect estimate: AUC 0.94 (training) and 0.84 (validation) (95% CI 0.89-0.98 (training), 0.71-0.96 (validation))
A nomogram integrating shear wave elastography, hypertension, and eGFR provides high diagnostic accuracy for non-invasively assessing moderate-severe renal fibrosis in CKD patients.
May support non-invasive fibrosis assessment in CKD; leaves open prospective validation before clinical use.
BACKGROUND: Non-invasive evaluation of renal fibrosis is still challenging. This study aimed to establish a nomogram based on shear wave elastography (SWE) and clinical features for the assessment of the severity of renal fibrosis in patients with chronic kidney disease (CKD). METHODS: One hundred and sixty-two patients with CKD who underwent kidney biopsy and SWE examination were prospectively enrolled between April 2019 and December 2021. Patients were classified into mildly or moderately-severely impaired group based on pathology results. All patients were randomly divided into a training (n = 113) or validation cohort (n = 49). Least absolute shrinkage and selection operator (LASSO) algorithm was used for data dimensionality reduction and feature selection. Then, a diagnostic nomogram incorporating the selected features was constructed using multivariable logistic regression analysis. Nomogram performance was evaluated for discrimination, calibration, and clinical utility in training and validation cohorts. RESULTS: The established SWE nomogram, which integrated SWE value, hypertension, and estimated glomerular filtration rate, showed fine calibration and discrimination in both training (area under the receiver operator characteristic curve (AUC) = 0.94; 95% confidence interval (CI) 0.89-0.98) and validation cohorts (AUC = 0.84; 95% CI 0.71-0.96). Significant improvement in net reclassification and integrated discrimination indicated that the SWE value is a valuable biomarker to assess moderate-severe renal impairment. Furthermore, decision curve analysis revealed that the SWE nomogram has clinical value. CONCLUSION: The proposed SWE nomogram showed favorable performance in determining individualized risk of moderate-severe renal pathological impairment in patients with CKD, which will help to facilitate clinical decision-making.
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Chen et al. (2022) conducted an observational in Chronic kidney disease (n=162). Shear wave elastography (SWE) nomogram was evaluated on Discrimination of moderate-severe renal pathological impairment (AUC 0.94 (training) and 0.84 (validation), 95% CI 0.89-0.98 (training), 0.71-0.96 (validation)). A nomogram integrating shear wave elastography, hypertension, and eGFR showed favorable discrimination for moderate-severe renal impairment in training (AUC 0.94) and validation (AUC 0.84) cohorts.
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