期刊
HUMAN PATHOLOGY
卷 45, 期 2, 页码 236-243出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.humpath.2013.08.019
关键词
Proteinuria; IgA nephropathy; Long-term outcome
类别
资金
- Yonsei University College of Medicine for [6-2012-0033]
- Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea [A102065]
Pathologic features can provide valuable information for determining prognosis in IgA nephropathy (IgAN). However, it is uncertain whether the Oxford classification, a new classification of IgAN, can predict renal outcome better than previous ones. We conducted a retrospective cohort study in 500 patients with biopsy-proven IgAN between January 2002 and December 2010 to compare the ability of the Haas and the Oxford classifications to predict renal outcome. Primary outcome was a doubling of the baseline serum creatinine concentration (D-SCr). During a mean follow-up of 68 months, 52(10.4%) and 35 (7.0%) developed D-SCr and end-stage renal disease, respectively. There were graded increases in the development of D-SCr in the higher Haas classes. In addition, the primary endpoint of D-SCr occurred more in patients with the Oxford M and T lesions than those without such lesions. In multivariate Cox regression analyses, the Haas class V (HR, 12.19; P = .002) and the Oxford T1 (hazard ratio [HR], 6.68; P < .001) and T2 (HR, 12.16; P < .001) lesions were independently associated with an increased risk of reaching D-SCr. Harrell's C index of each multivariate model with the Haas and the Oxford classification was 0.867 (P = .015) and 0.881 (P = .004), respectively. This was significantly higher than that of model with clinical factors only (C = 0.819). However, there was no difference in C-statistics between the 2 models with the Haas and the Oxford classifications (P = .348). This study suggests that the Haas and the Oxford classifications are comparable in predicting progression of IgAN. (C) 2014 Elsevier Inc. All rights reserved.
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