Comparative Performance of the ANCLA Risk Score and Established Prognostic Models for Predicting ESKD in ANCA-Associated Glomerulonephritis: A Latin American Cohort.
5 affiliations
- 1Division of Nephrology Hospital San Vicente Fundación Medellín Colombia.
- 2Department of Internal Medicine Division of Nephrology University of Antioquia Medellín Colombia udea.edu.co.
- 3Department of Internal Medicine Division of Rheumatology University of Antioquia Medellín Colombia udea.edu.co.
- 4Division of Rheumatology Hospital San Vicente Fundación Medellín Colombia.
- 5Department of Pathology University of Antioquia Medellín Colombia udea.edu.co.
Abstract
Background
Prognostic tools for kidney outcomes in ANCA-associated vasculitis (AAV) were developed mainly in European and North American populations, and their performance in Hispanic populations remains less well characterized. ANCA in Latin America (ANCLA) was previously developed and internally validated in a Colombian cohort to predict end-stage kidney disease (ESKD).Objective
To compare the prognostic performance of ANCLA with the Berden classification, Renal Risk Score (RRS), Mayo Clinic Chronicity Score (MCCS), and the ANCA Kidney Risk Score (AKRiS) for ESKD prediction in ANCA-associated glomerulonephritis.Methods
This secondary comparative analysis used the previously described ANCLA derivation cohort of 164 adults with biopsy-proven pauci-immune necrotizing and/or crescentic glomerulonephritis treated from 2011 to 2024 at a tertiary referral center in Colombia. The five prognostic systems were evaluated in the same population using Kaplan-Meier analyses, Harrell's C-index, and 1- and 2-year ROC analyses. Pairwise AUC differences between ANCLA and each comparator were formally assessed.Results
During a median follow-up of 12.9 months, 63 patients (38.4%) progressed to ESKD. ANCLA showed the most favorable overall discrimination (C-index 0.801; AUC 0.890 at 1 year and 0.896 at 2 years), followed by AKRiS (C-index 0.760) and RRS (0.749); MCCS (0.673) and Berden (0.640) showed lower discrimination. ANCLA had significantly higher AUCs than MCCS and Berden at both horizons, whereas differences versus AKRiS and RRS were smaller. ESKD occurred in 7.3% of the ANCLA low-risk group and 82.5% of the very-high-risk group.Conclusion
In this high-risk, predominantly Hispanic Latin American cohort, ANCLA showed the most favorable short-term discrimination, while AKRiS and RRS also performed well. Independent external validation remains necessary.
Related
- Triglycerides, Total Cholesterol, and Body Weight Index Demonstrates High Discriminative Performance for Metabolic Syndrome: A Comparative Study with Established Cardiometabolic and Inflammatory Indices
- Comparative Prognostic Performance of Inflammatory and Immunonutritional Indices in Acute Pancreatitis: A Head-to-Head Cohort Study
- Circulating leucine-rich α-2 glycoprotein 1 and its prognostic significance in established heart failure
- Comparative Prognostic Performance of 18 Routine Laboratory-Derived Indices for In-Hospital Mortality in Patients with COVID-19
- Comparative performance of mSOFA, APACHE II, APPS, and MPM II scores in predicting mortality among mechanically ventilated surgical ICU patients: a prospective cohort study
BibTeX
@article{rodeloceballos2026comparative,
title = {{Comparative Performance of the ANCLA Risk Score and Established Prognostic Models for Predicting ESKD in ANCA-Associated Glomerulonephritis: A Latin American Cohort.}},
author = {Joaquín Rodelo-Ceballos and Mauricio Restrepo-Escobar and Mayra Estacio and Carlos Muñoz-Vahos and Alejandra Taborda},
journal = {International journal of nephrology},
year = {2026},
month = oct,
doi = {10.1155/ijne/5595479},
url = {https://europepmc.org/article/MED/42841032},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Performance of the ANCLA Risk Score and Established Prognostic Models for Predicting ESKD in ANCA-Associated Glomerulonephritis: A Latin American Cohort.
AU - Joaquín Rodelo-Ceballos
AU - Mauricio Restrepo-Escobar
AU - Mayra Estacio
AU - Carlos Muñoz-Vahos
AU - Alejandra Taborda
PY - 2026
DA - 2026/10/06
JO - International journal of nephrology
DO - 10.1155/ijne/5595479
UR - https://europepmc.org/article/MED/42841032
AB - Background Prognostic tools for kidney outcomes in ANCA-associated vasculitis (AAV) were developed mainly in European and North American populations, and their performance in Hispanic populations remains less well characterized. ANCA in Latin America (ANCLA) was previously developed and internally validated in a Colombian cohort to predict end-stage kidney disease (ESKD).Objective To compare the prognostic performance of ANCLA with the Berden classification, Renal Risk Score (RRS), Mayo Clinic Chronicity Score (MCCS), and the ANCA Kidney Risk Score (AKRiS) for ESKD prediction in ANCA-associated glomerulonephritis.Methods This secondary comparative analysis used the previously described ANCLA derivation cohort of 164 adults with biopsy-proven pauci-immune necrotizing and/or crescentic glomerulonephritis treated from 2011 to 2024 at a tertiary referral center in Colombia. The five prognostic systems were evaluated in the same population using Kaplan-Meier analyses, Harrell's C-index, and 1- and 2-year ROC analyses. Pairwise AUC differences between ANCLA and each comparator were formally assessed.Results During a median follow-up of 12.9 months, 63 patients (38.4%) progressed to ESKD. ANCLA showed the most favorable overall discrimination (C-index 0.801; AUC 0.890 at 1 year and 0.896 at 2 years), followed by AKRiS (C-index 0.760) and RRS (0.749); MCCS (0.673) and Berden (0.640) showed lower discrimination. ANCLA had significantly higher AUCs than MCCS and Berden at both horizons, whereas differences versus AKRiS and RRS were smaller. ESKD occurred in 7.3% of the ANCLA low-risk group and 82.5% of the very-high-risk group.Conclusion In this high-risk, predominantly Hispanic Latin American cohort, ANCLA showed the most favorable short-term discrimination, while AKRiS and RRS also performed well. Independent external validation remains necessary.
SN - 2090-214X
SN - 2090-2158
ER -