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

研究成果: Article

1 引用 (Scopus)

抄録

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.

元の言語English
ジャーナルClinical and Experimental Nephrology
DOI
出版物ステータスAccepted/In press - 2018 1 1

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Immunoglobulin A
Dialysis
IGA Glomerulonephritis
Chronic Kidney Failure
Glomerular Filtration Rate
Proteins
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

これを引用

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title = "A grading system that predicts the risk of dialysis induction in IgA nephropathy patients based on the combination of the clinical and histological severity",
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.",
keywords = "Clinical classification, Histological classification, IgA nephropathy, Receiver-operating characteristic analysis, Renal biopsy",
author = "{for The Special IgA Nephropathy Study Group} and Hideo Okonogi and Tetsuya Kawamura and Kensuke Joh and Kentaro Koike and Yoichi Miyazaki and Makoto Ogura and Nobuo Tsuboi and Keita Hirano and Masato Matsushima and Takashi Yokoo and Satoshi Horikoshi and Yusuke Suzuki and Takashi Yasuda and Sayuri Shirai and Takanori Shibata and Motoshi Hattori and Yuko Akioka and Ritsuko Katafuchi and Akinori Hashiguchi and Satoshi Hisano and Akira Shimizu and Kenjiro Kimura and Shoichi Maruyama and Seiichi Matsuo and Yasuhiko Tomino",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s10157-018-1657-0",
language = "English",
journal = "Clinical and Experimental Nephrology",
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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

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U2 - 10.1007/s10157-018-1657-0

DO - 10.1007/s10157-018-1657-0

M3 - Article

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AN - SCOPUS:85055685154

JO - Clinical and Experimental Nephrology

JF - Clinical and Experimental Nephrology

SN - 1342-1751

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