Validation of the Japanese histologic classification 2013 of immunoglobulin A nephropathy for prediction of long-term prognosis in a Japanese single-center ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-07-08

AUTHORS

Ryuta Sato, Kensuke Joh, Atsushi Komatsuda, Hiroshi Ohtani, Shin Okuyama, Masaru Togashi, Ayumi Omokawa, Mizuho Nara, Daisuke Nagata, Eiji Kusano, Ken-ichi Sawada, Hideki Wakui

ABSTRACT

BackgroundA new Japanese histologic classification (JHC) of immunoglobulin A nephropathy (IgAN) for prediction of long-term prognosis was proposed in 2013. The goal of this study was to validate the JHC system in a Japanese single-center cohort.MethodsA retrospective study was conducted in 198 Japanese adult patients with IgAN. Clinical findings including blood pressure, urinary protein, estimated glomerular filtration rate (eGFR), and outcomes were evaluated in these patients. The glomerular lesion percentage score (GLPS) [number of glomeruli with cellular crescents, fibrocellular crescents, global sclerosis, segmental sclerosis, or fibrous crescents/number of total obtained glomeruli × 100 (%)] was assessed in each patient and categorized into histologic grades (HGs) of HG1 (<25 %), HG2 (25–49 %), and HG3/4 (≥50 %). Associations of GLPS (HG) with disease progression (50 % eGFR decline or end-stage renal disease requiring dialysis) within 10 years after biopsy and the rate of annual eGFR decline were examined.ResultsDuring a median follow-up period of 12.0 years after biopsy, disease progression occurred in 12.8 % (12/94) of HG1 patients, 32.3 % (21/65) of HG2 patients, and 46.2 % (18/39) of HG3/4 patients. The risk of disease progression was significantly higher in the HG2 and HG3/4 groups than in the HG1 group (odds ratios: 3.3 and 5.9 vs. 1). A higher GLPS was significantly associated with a higher risk of disease progression and a greater annual eGFR decline.ConclusionThe newly proposed JHC system 2013 based on GLPS (HG) was well correlated with long-term prognosis in our cohort of Japanese adult patients with IgAN. More... »

PAGES

411-418

References to SciGraph publications

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URI

http://scigraph.springernature.com/pub.10.1007/s10157-014-1004-z

DOI

http://dx.doi.org/10.1007/s10157-014-1004-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1033188554

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25002018


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