Predictive value of sub classification of focal segmental glomerular sclerosis in Oxford classification of IgA nephropathy

The Oxford classification of IgA nephropathy (IgAN) was revised in 2016 which lacked sufficient evidence for prognostic value of subclassification of focal segmental glomerular sclerosis (S lesion), and the proper proportion of S lesion for subclassification remains undetermined. This study aimed to...

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Veröffentlicht in:Annals of medicine (Helsinki) 2021-01, Vol.53 (1), p.587-595
Hauptverfasser: Yu, Fang, Zhu, Xuejing, Yuan, Shuguang, Chen, Xiaojun, Li, Zheng, Qu, Zhong, Liu, Hong, Sun, Lin, Liu, Fuyou
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Sprache:eng
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Zusammenfassung:The Oxford classification of IgA nephropathy (IgAN) was revised in 2016 which lacked sufficient evidence for prognostic value of subclassification of focal segmental glomerular sclerosis (S lesion), and the proper proportion of S lesion for subclassification remains undetermined. This study aimed to explore the predictive value of the new subclassification of S score on renal outcomes of IgAN patients. 348 patients with IgAN-associated S lesion were enrolled. According to the optimal cut-off of 25% established by receiver operating characteristic (ROC) curves, we divided S1 patients into two groups: S1a group (S lesion < 25%) and S1b group (S lesion ≥ 25%). IgAN patients with mild lesion (M0E0S0T0C0) were set as the control group. The clinical features at renal biopsy, pathological findings, and follow-up parameters (follow-up time ranged from 1 to 5 years) were collected. We used univariate and multivariate analyses to assess whether the subclassification of S score could refine risk prediction and clinical utility. We demonstrated that S lesion ≥ 25% was associated with a more rapid GFR loss and a lower rate of complete remission of proteinuria even adjusted for multiple clinic pathological variables, compared to S1a group (All p values
ISSN:0785-3890
1365-2060
DOI:10.1080/07853890.2021.1897664