Abstract
Histological classification is essential in the clinical management of immunoglobulin A nephropathy (IgAN). However, there are limitations in predicting the prognosis of IgAN based on histological information alone, which suggests the need for better prognostic models. Therefore, we defined a prognostic model by combining the grade of clinical severity with the histological grading system by the following processes. We included 270 patients and explored the clinical variables associated with progression to end-stage renal disease (ESRD). Then, we created a predictive clinical grading system and defined the risk grades for dialysis induction by a combination of the clinical grade (CG) and the histological grade (HG). A logistic regression analysis revealed that the 24-h urinary protein excretion (UPE) and the estimated glomerular filtration rate (eGFR) were significant independent variables. We selected UPE of 0.5 g/day and eGFR of 60 ml/min/1.73 m2 as the threshold values for the classification of CG. The risk of progression to ESRD of patients with CG II and III was significantly higher than that of patients with CG I. The patients were then re-classified into nine compartments based on the combination of CG and HG. Furthermore, the nine compartments were grouped into four risk groups. The risk of ESRD in the moderate, high, and super-high-risk groups was significantly higher than that in the low-risk group. Herein, we are giving a detailed description of our grading system for IgA nephropathy that predicted the risk of dialysis based on the combination of CG and HG.
| Original language | English |
|---|---|
| Journal | Clinical and Experimental Nephrology |
| DOIs | |
| Publication status | Accepted/In press - 2018 Jan 1 |
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Keywords
- Clinical classification
- Histological classification
- IgA nephropathy
- Receiver-operating characteristic analysis
- Renal biopsy
ASJC Scopus subject areas
- Physiology
- Nephrology
- Physiology (medical)
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A grading system that predicts the risk of dialysis induction in IgA nephropathy patients based on the combination of the clinical and histological severity. / for The Special IgA Nephropathy Study Group.
In: Clinical and Experimental Nephrology, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A grading system that predicts the risk of dialysis induction in IgA nephropathy patients based on the combination of the clinical and histological severity
AU - for The Special IgA Nephropathy Study Group
AU - Okonogi, Hideo
AU - Kawamura, Tetsuya
AU - Joh, Kensuke
AU - Koike, Kentaro
AU - Miyazaki, Yoichi
AU - Ogura, Makoto
AU - Tsuboi, Nobuo
AU - Hirano, Keita
AU - Matsushima, Masato
AU - Yokoo, Takashi
AU - Horikoshi, Satoshi
AU - Suzuki, Yusuke
AU - Yasuda, Takashi
AU - Shirai, Sayuri
AU - Shibata, Takanori
AU - Hattori, Motoshi
AU - Akioka, Yuko
AU - Katafuchi, Ritsuko
AU - Hashiguchi, Akinori
AU - Hisano, Satoshi
AU - Shimizu, Akira
AU - Kimura, Kenjiro
AU - Maruyama, Shoichi
AU - Matsuo, Seiichi
AU - Tomino, Yasuhiko
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Histological classification is essential in the clinical management of immunoglobulin A nephropathy (IgAN). However, there are limitations in predicting the prognosis of IgAN based on histological information alone, which suggests the need for better prognostic models. Therefore, we defined a prognostic model by combining the grade of clinical severity with the histological grading system by the following processes. We included 270 patients and explored the clinical variables associated with progression to end-stage renal disease (ESRD). Then, we created a predictive clinical grading system and defined the risk grades for dialysis induction by a combination of the clinical grade (CG) and the histological grade (HG). A logistic regression analysis revealed that the 24-h urinary protein excretion (UPE) and the estimated glomerular filtration rate (eGFR) were significant independent variables. We selected UPE of 0.5 g/day and eGFR of 60 ml/min/1.73 m2 as the threshold values for the classification of CG. The risk of progression to ESRD of patients with CG II and III was significantly higher than that of patients with CG I. The patients were then re-classified into nine compartments based on the combination of CG and HG. Furthermore, the nine compartments were grouped into four risk groups. The risk of ESRD in the moderate, high, and super-high-risk groups was significantly higher than that in the low-risk group. Herein, we are giving a detailed description of our grading system for IgA nephropathy that predicted the risk of dialysis based on the combination of CG and HG.
AB - Histological classification is essential in the clinical management of immunoglobulin A nephropathy (IgAN). However, there are limitations in predicting the prognosis of IgAN based on histological information alone, which suggests the need for better prognostic models. Therefore, we defined a prognostic model by combining the grade of clinical severity with the histological grading system by the following processes. We included 270 patients and explored the clinical variables associated with progression to end-stage renal disease (ESRD). Then, we created a predictive clinical grading system and defined the risk grades for dialysis induction by a combination of the clinical grade (CG) and the histological grade (HG). A logistic regression analysis revealed that the 24-h urinary protein excretion (UPE) and the estimated glomerular filtration rate (eGFR) were significant independent variables. We selected UPE of 0.5 g/day and eGFR of 60 ml/min/1.73 m2 as the threshold values for the classification of CG. The risk of progression to ESRD of patients with CG II and III was significantly higher than that of patients with CG I. The patients were then re-classified into nine compartments based on the combination of CG and HG. Furthermore, the nine compartments were grouped into four risk groups. The risk of ESRD in the moderate, high, and super-high-risk groups was significantly higher than that in the low-risk group. Herein, we are giving a detailed description of our grading system for IgA nephropathy that predicted the risk of dialysis based on the combination of CG and HG.
KW - Clinical classification
KW - Histological classification
KW - IgA nephropathy
KW - Receiver-operating characteristic analysis
KW - Renal biopsy
UR - http://www.scopus.com/inward/record.url?scp=85055685154&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055685154&partnerID=8YFLogxK
U2 - 10.1007/s10157-018-1657-0
DO - 10.1007/s10157-018-1657-0
M3 - Article
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
SN - 1342-1751
ER -