Table 1.
Criteria for risk assessment of progressive loss of kidney function
| Low risk | Moderate risk | High risk | Very high risk | |
|---|---|---|---|---|
| eGFR | Normal | Normal | <60 ml/min per 1.73 m2 | Rapid deterioration |
| Proteinuria | <3.5 g/d and/or serum albumin >30 g/l | >4 g/d and no decrease >50% after 6 mo of supportive therapy | >8 g/d for >6 months | Life-threatening nephrotic syndrome |
| PLA2R Aba | <50 RU/ml | >150 RU/ml | ||
| Low molecular weight proteinuria | Mild | High | High (in 2 urine samples collected with interval of 6–12 mo) | |
| Urinary IgG | <250 mg/d | >250 mg/d | ||
| Selectivity indexb | <0.15 | >0.20 |
eGFR, estimated glomerular filtration rate; PLA2R Ab, M-type phospholipase A2 receptor antibody.
Modified according to provisional Kidney Disease: Improving Global Outcomes guidelines (public review draft).22
a
Serial measurement every 3 to 6 months should be performed, as changes of PLA2R Ab levels precede signs. Dynamics of PLA2R Ab levels therefore may be of additional value for risk estimation.
b
Ratio of clearance of high molecular weight molecules (IgG, IgM, α2-macroglobulin) to that of albumin.78