Overestimation of the risk of progression to end-stage renal disease in the poor prognosis' group according to the 2002 Japanese histological classification for immunoglobulin a nephropathy

Yoichi Miyazaki, Tetsuya Kawamura, Kensuke Joh, Hideo Okonogi, Kentaro Koike, Yasunori Utsunomiya, Makoto Ogura, Masato Matsushima, Mitsuhiro Yoshimura, Satoshi Horikoshi, Yusuke Suzuki, Akira Furusu, Takashi Yasuda, Sayuri Shirai, Takanori Shibata, Masayuki Endoh, Motoshi Hattori, Yuko Akioka, Ritsuko Katafuti, Akinori HashiguchiKenjiro Kimura, Seiichi Matsuo, Yasuhiko Tomino

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Abstract

Background: The current (2012) histological classification of immunoglobulin A nephropathy was established using a case-control study of 287 patients. However, the risk of progression to end-stage renal disease (ESRD) has not been validated for the previous (2002) classification. This study aimed to determine whether the previous classification could identify the risk of long-term renal outcome through re-analysis of the 2012 cohort. Methods: On the basis of the 2002 classification, namely 'good prognosis', 'relatively good prognosis', 'relatively poor prognosis', and 'poor prognosis', we examined the clinical data at the time of biopsy, the correlation between the 2002 classification and long-term renal outcomes, and a patient-by-patient correlation between the 2002 and 2012 classification systems. This was performed by analyzing samples from the 287 patients used to establish the 2012 classification. Results: The rate of decline of estimated glomerular filtration rate was greater and the odds ratio of progression to ESRD was higher in the 'poor prognosis' group. In contrast, the odds ratio for renal death was comparable between the groups described as 'relatively poor prognosis' and 'relatively good prognosis' in the 2002 classification. Many patients in the 2002 classification were classified with a lower histological grade in the current classification, but none were classified with a higher grade. Conclusions: The 2002 classification could also identify the risk of progression to ESRD. However, it was overestimated for patients in the 'poor prognosis' group in the 2002 classification, as that group included patients with milder histological damage.

Original languageEnglish
Pages (from-to)475-480
Number of pages6
JournalClinical and Experimental Nephrology
Volume18
Issue number3
DOIs
Publication statusPublished - 2014

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Keywords

  • Case-control study
  • Current histological classification
  • EGFR decline
  • IgA nephropathy classification
  • Multicenter
  • Tuft adhesion

ASJC Scopus subject areas

  • Nephrology
  • Physiology
  • Physiology (medical)

Cite this

Miyazaki, Y., Kawamura, T., Joh, K., Okonogi, H., Koike, K., Utsunomiya, Y., Ogura, M., Matsushima, M., Yoshimura, M., Horikoshi, S., Suzuki, Y., Furusu, A., Yasuda, T., Shirai, S., Shibata, T., Endoh, M., Hattori, M., Akioka, Y., Katafuti, R., ... Tomino, Y. (2014). Overestimation of the risk of progression to end-stage renal disease in the poor prognosis' group according to the 2002 Japanese histological classification for immunoglobulin a nephropathy. Clinical and Experimental Nephrology, 18(3), 475-480. https://doi.org/10.1007/s10157-013-0848-y