Systemic lupus international collaborating clinics renal activity/response exercise: Development of a renal activity score and renal response index

Michelle Petri, Nuntana Kasitanon, Shin Seok Lee, Kimberly Link, Laurence Magder, Sang Cheol Bae, John G. Hanly, David A. Isenberg, Ola Nived, Gunnar Sturfelt, Ronald Van Vollenhoven, Daniel J. Wallace, Graciela S. Alarcón, Dwomoa Adu, Carmen Avila-Casado, Sasha R. Bernatsky, Ian N. Bruce, Ann E. Clarke, Gabriel Contreras, Derek M. FineDafna D. Gladman, Caroline Gordon, Kenneth C. Kalunian, Michael P. Madaio, Brad H. Rovin, Jorge Sanchez-Guerrero, Kristjan Steinsson, Cynthia Aranow, James E. Balow, Jill P. Buyon, Ellen M. Ginzler, Munther A. Khamashta, Murray B. Urowitz, Mary Anne Dooley, Joan T. Merrill, Rosalind Ramsey-Goldman, Josef Font, James Tumlin, Thomas Stoll, Asad Zoma

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective. To develop a measure of renal activity in systemic lupus erythematosus and use it to develop a renal response index. Methods. Abstracted data from the medical records of 215 patients with lupus nephritis were sent to 8 nephrologists and 29 rheumatologists for rating. Seven nephrologists and 22 rheumatologists completed the ratings. Each physician rated each patient visit with respect to renal disease activity (none, mild, moderate, or severe). Using the most commonly selected rating for each patient as the gold standard, stepwise regression modeling was performed to identify the variables most related to renal disease activity, and these variables were then used to create an activity score. This activity score could then be applied to 2 consecutive visits to define a renal response index. Results. The renal activity score was computed as follows: proteinuria 0.5-1 gm/day (3 points), proteinuria >1-3 gm/day (5 points), proteinuria >3 gm/day (11 points), urine red blood cell count >10/high-power field (3 points), and urine white blood cell count >10/high-power field (1 point). The chance-adjusted agreement between the renal response index derived from the activity score applied to the paired visits and the plurality physician response rating was 0.69 (95% confidence interval 0.59-0.79). Conclusion. Ratings derived from this index for rating of renal response showed reasonable agreement with physician ratings in a pilot study. The index will require further refinement, testing, and validation. A data-driven approach to create renal activity and renal response indices will be useful in both clinical care and research settings.

Original languageEnglish (US)
Pages (from-to)1784-1788
Number of pages5
JournalArthritis and Rheumatism
Volume58
Issue number6
DOIs
StatePublished - Jun 1 2008

Fingerprint

Ambulatory Care Facilities
Exercise
Kidney
Proteinuria
Physicians
Urine
Lupus Nephritis
Erythrocyte Count
Leukocyte Count
Systemic Lupus Erythematosus
Medical Records
Confidence Intervals

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

Cite this

Systemic lupus international collaborating clinics renal activity/response exercise : Development of a renal activity score and renal response index. / Petri, Michelle; Kasitanon, Nuntana; Lee, Shin Seok; Link, Kimberly; Magder, Laurence; Bae, Sang Cheol; Hanly, John G.; Isenberg, David A.; Nived, Ola; Sturfelt, Gunnar; Van Vollenhoven, Ronald; Wallace, Daniel J.; Alarcón, Graciela S.; Adu, Dwomoa; Avila-Casado, Carmen; Bernatsky, Sasha R.; Bruce, Ian N.; Clarke, Ann E.; Contreras, Gabriel; Fine, Derek M.; Gladman, Dafna D.; Gordon, Caroline; Kalunian, Kenneth C.; Madaio, Michael P.; Rovin, Brad H.; Sanchez-Guerrero, Jorge; Steinsson, Kristjan; Aranow, Cynthia; Balow, James E.; Buyon, Jill P.; Ginzler, Ellen M.; Khamashta, Munther A.; Urowitz, Murray B.; Dooley, Mary Anne; Merrill, Joan T.; Ramsey-Goldman, Rosalind; Font, Josef; Tumlin, James; Stoll, Thomas; Zoma, Asad.

In: Arthritis and Rheumatism, Vol. 58, No. 6, 01.06.2008, p. 1784-1788.

Research output: Contribution to journalArticle

Petri, M, Kasitanon, N, Lee, SS, Link, K, Magder, L, Bae, SC, Hanly, JG, Isenberg, DA, Nived, O, Sturfelt, G, Van Vollenhoven, R, Wallace, DJ, Alarcón, GS, Adu, D, Avila-Casado, C, Bernatsky, SR, Bruce, IN, Clarke, AE, Contreras, G, Fine, DM, Gladman, DD, Gordon, C, Kalunian, KC, Madaio, MP, Rovin, BH, Sanchez-Guerrero, J, Steinsson, K, Aranow, C, Balow, JE, Buyon, JP, Ginzler, EM, Khamashta, MA, Urowitz, MB, Dooley, MA, Merrill, JT, Ramsey-Goldman, R, Font, J, Tumlin, J, Stoll, T & Zoma, A 2008, 'Systemic lupus international collaborating clinics renal activity/response exercise: Development of a renal activity score and renal response index', Arthritis and Rheumatism, vol. 58, no. 6, pp. 1784-1788. https://doi.org/10.1002/art.23456
Petri, Michelle ; Kasitanon, Nuntana ; Lee, Shin Seok ; Link, Kimberly ; Magder, Laurence ; Bae, Sang Cheol ; Hanly, John G. ; Isenberg, David A. ; Nived, Ola ; Sturfelt, Gunnar ; Van Vollenhoven, Ronald ; Wallace, Daniel J. ; Alarcón, Graciela S. ; Adu, Dwomoa ; Avila-Casado, Carmen ; Bernatsky, Sasha R. ; Bruce, Ian N. ; Clarke, Ann E. ; Contreras, Gabriel ; Fine, Derek M. ; Gladman, Dafna D. ; Gordon, Caroline ; Kalunian, Kenneth C. ; Madaio, Michael P. ; Rovin, Brad H. ; Sanchez-Guerrero, Jorge ; Steinsson, Kristjan ; Aranow, Cynthia ; Balow, James E. ; Buyon, Jill P. ; Ginzler, Ellen M. ; Khamashta, Munther A. ; Urowitz, Murray B. ; Dooley, Mary Anne ; Merrill, Joan T. ; Ramsey-Goldman, Rosalind ; Font, Josef ; Tumlin, James ; Stoll, Thomas ; Zoma, Asad. / Systemic lupus international collaborating clinics renal activity/response exercise : Development of a renal activity score and renal response index. In: Arthritis and Rheumatism. 2008 ; Vol. 58, No. 6. pp. 1784-1788.
@article{de033d160b7b43aa9e7899e899f4984c,
title = "Systemic lupus international collaborating clinics renal activity/response exercise: Development of a renal activity score and renal response index",
abstract = "Objective. To develop a measure of renal activity in systemic lupus erythematosus and use it to develop a renal response index. Methods. Abstracted data from the medical records of 215 patients with lupus nephritis were sent to 8 nephrologists and 29 rheumatologists for rating. Seven nephrologists and 22 rheumatologists completed the ratings. Each physician rated each patient visit with respect to renal disease activity (none, mild, moderate, or severe). Using the most commonly selected rating for each patient as the gold standard, stepwise regression modeling was performed to identify the variables most related to renal disease activity, and these variables were then used to create an activity score. This activity score could then be applied to 2 consecutive visits to define a renal response index. Results. The renal activity score was computed as follows: proteinuria 0.5-1 gm/day (3 points), proteinuria >1-3 gm/day (5 points), proteinuria >3 gm/day (11 points), urine red blood cell count >10/high-power field (3 points), and urine white blood cell count >10/high-power field (1 point). The chance-adjusted agreement between the renal response index derived from the activity score applied to the paired visits and the plurality physician response rating was 0.69 (95{\%} confidence interval 0.59-0.79). Conclusion. Ratings derived from this index for rating of renal response showed reasonable agreement with physician ratings in a pilot study. The index will require further refinement, testing, and validation. A data-driven approach to create renal activity and renal response indices will be useful in both clinical care and research settings.",
author = "Michelle Petri and Nuntana Kasitanon and Lee, {Shin Seok} and Kimberly Link and Laurence Magder and Bae, {Sang Cheol} and Hanly, {John G.} and Isenberg, {David A.} and Ola Nived and Gunnar Sturfelt and {Van Vollenhoven}, Ronald and Wallace, {Daniel J.} and Alarc{\'o}n, {Graciela S.} and Dwomoa Adu and Carmen Avila-Casado and Bernatsky, {Sasha R.} and Bruce, {Ian N.} and Clarke, {Ann E.} and Gabriel Contreras and Fine, {Derek M.} and Gladman, {Dafna D.} and Caroline Gordon and Kalunian, {Kenneth C.} and Madaio, {Michael P.} and Rovin, {Brad H.} and Jorge Sanchez-Guerrero and Kristjan Steinsson and Cynthia Aranow and Balow, {James E.} and Buyon, {Jill P.} and Ginzler, {Ellen M.} and Khamashta, {Munther A.} and Urowitz, {Murray B.} and Dooley, {Mary Anne} and Merrill, {Joan T.} and Rosalind Ramsey-Goldman and Josef Font and James Tumlin and Thomas Stoll and Asad Zoma",
year = "2008",
month = "6",
day = "1",
doi = "10.1002/art.23456",
language = "English (US)",
volume = "58",
pages = "1784--1788",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

TY - JOUR

T1 - Systemic lupus international collaborating clinics renal activity/response exercise

T2 - Development of a renal activity score and renal response index

AU - Petri, Michelle

AU - Kasitanon, Nuntana

AU - Lee, Shin Seok

AU - Link, Kimberly

AU - Magder, Laurence

AU - Bae, Sang Cheol

AU - Hanly, John G.

AU - Isenberg, David A.

AU - Nived, Ola

AU - Sturfelt, Gunnar

AU - Van Vollenhoven, Ronald

AU - Wallace, Daniel J.

AU - Alarcón, Graciela S.

AU - Adu, Dwomoa

AU - Avila-Casado, Carmen

AU - Bernatsky, Sasha R.

AU - Bruce, Ian N.

AU - Clarke, Ann E.

AU - Contreras, Gabriel

AU - Fine, Derek M.

AU - Gladman, Dafna D.

AU - Gordon, Caroline

AU - Kalunian, Kenneth C.

AU - Madaio, Michael P.

AU - Rovin, Brad H.

AU - Sanchez-Guerrero, Jorge

AU - Steinsson, Kristjan

AU - Aranow, Cynthia

AU - Balow, James E.

AU - Buyon, Jill P.

AU - Ginzler, Ellen M.

AU - Khamashta, Munther A.

AU - Urowitz, Murray B.

AU - Dooley, Mary Anne

AU - Merrill, Joan T.

AU - Ramsey-Goldman, Rosalind

AU - Font, Josef

AU - Tumlin, James

AU - Stoll, Thomas

AU - Zoma, Asad

PY - 2008/6/1

Y1 - 2008/6/1

N2 - Objective. To develop a measure of renal activity in systemic lupus erythematosus and use it to develop a renal response index. Methods. Abstracted data from the medical records of 215 patients with lupus nephritis were sent to 8 nephrologists and 29 rheumatologists for rating. Seven nephrologists and 22 rheumatologists completed the ratings. Each physician rated each patient visit with respect to renal disease activity (none, mild, moderate, or severe). Using the most commonly selected rating for each patient as the gold standard, stepwise regression modeling was performed to identify the variables most related to renal disease activity, and these variables were then used to create an activity score. This activity score could then be applied to 2 consecutive visits to define a renal response index. Results. The renal activity score was computed as follows: proteinuria 0.5-1 gm/day (3 points), proteinuria >1-3 gm/day (5 points), proteinuria >3 gm/day (11 points), urine red blood cell count >10/high-power field (3 points), and urine white blood cell count >10/high-power field (1 point). The chance-adjusted agreement between the renal response index derived from the activity score applied to the paired visits and the plurality physician response rating was 0.69 (95% confidence interval 0.59-0.79). Conclusion. Ratings derived from this index for rating of renal response showed reasonable agreement with physician ratings in a pilot study. The index will require further refinement, testing, and validation. A data-driven approach to create renal activity and renal response indices will be useful in both clinical care and research settings.

AB - Objective. To develop a measure of renal activity in systemic lupus erythematosus and use it to develop a renal response index. Methods. Abstracted data from the medical records of 215 patients with lupus nephritis were sent to 8 nephrologists and 29 rheumatologists for rating. Seven nephrologists and 22 rheumatologists completed the ratings. Each physician rated each patient visit with respect to renal disease activity (none, mild, moderate, or severe). Using the most commonly selected rating for each patient as the gold standard, stepwise regression modeling was performed to identify the variables most related to renal disease activity, and these variables were then used to create an activity score. This activity score could then be applied to 2 consecutive visits to define a renal response index. Results. The renal activity score was computed as follows: proteinuria 0.5-1 gm/day (3 points), proteinuria >1-3 gm/day (5 points), proteinuria >3 gm/day (11 points), urine red blood cell count >10/high-power field (3 points), and urine white blood cell count >10/high-power field (1 point). The chance-adjusted agreement between the renal response index derived from the activity score applied to the paired visits and the plurality physician response rating was 0.69 (95% confidence interval 0.59-0.79). Conclusion. Ratings derived from this index for rating of renal response showed reasonable agreement with physician ratings in a pilot study. The index will require further refinement, testing, and validation. A data-driven approach to create renal activity and renal response indices will be useful in both clinical care and research settings.

UR - http://www.scopus.com/inward/record.url?scp=45349102050&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=45349102050&partnerID=8YFLogxK

U2 - 10.1002/art.23456

DO - 10.1002/art.23456

M3 - Article

C2 - 18512819

AN - SCOPUS:45349102050

VL - 58

SP - 1784

EP - 1788

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

IS - 6

ER -