The Japanese Histologic Classification and T-score in the Oxford Classification system could predict renal outcome in Japanese IgA nephropathy patients

Clin Exp Nephrol. 2017 Dec;21(6):986-994. doi: 10.1007/s10157-017-1393-x. Epub 2017 Mar 27.

Abstract

Background: The Oxford Classification is utilized globally, but has not been fully validated. In this study, we conducted a comparative analysis between the Oxford Classification and Japanese Histologic Classification (JHC) to predict renal outcome in Japanese patients with IgA nephropathy (IgAN).

Methods: A retrospective cohort study including 86 adult IgAN patients was conducted. The Oxford Classification and the JHC were evaluated by 7 independent specialists. The JHC, MEST score in the Oxford Classification, and crescents were analyzed in association with renal outcome, defined as a 50% increase in serum creatinine.

Results: In multivariate analysis without the JHC, only the T score was significantly associated with renal outcome. While, a significant association was revealed only in the JHC on multivariate analysis with JHC.

Conclusions: The JHC and T score in the Oxford Classification were associated with renal outcome among Japanese patients with IgAN. Superiority of the JHC as a predictive index should be validated with larger study population and cohort studies in different ethnicities.

Keywords: ESRD; IgA nephropathy; Japanese Histologic Classification; Oxford Classification; Renal pathology.

MeSH terms

  • Adult
  • Female
  • Glomerulonephritis, IGA / complications
  • Glomerulonephritis, IGA / epidemiology
  • Glomerulonephritis, IGA / pathology*
  • Humans
  • Japan / epidemiology
  • Kidney / pathology*
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / immunology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index*
  • Young Adult