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Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update

R. Coppo, G. D'Arrigo, G. Tripepi, ML. Russo, ISD. Roberts, S. Bellur, D. Cattran, TH. Cook, J. Feehally, V. Tesar, D. Maixnerova, L. Peruzzi, A. Amore, S. Lundberg, AM. Di Palma, L. Gesualdo, F. Emma, C. Rollino, M. Praga, L. Biancone, A. Pani,...

. 2020 ; 35 (6) : 1002-1009. [pub] 20200601

Jazyk angličtina Země Velká Británie

Typ dokumentu časopisecké články, práce podpořená grantem, validační studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc20028140

BACKGROUND: It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up. METHODS: In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1-10.8)]. RESULTS: In this extended analysis, M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%). CONCLUSION: Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.

Cellular Pathology Oxford University Hospital Oxford UK

CNR IFC Epidemiology Reggio Calabria Italy

Department of Nephrology and Dialysis OSGB Turin Italy

Department of Nephrology and Kidney Transplantation University Hospital of Patras Patras Greece

Department of Nephrology and Pathology Radboud University Medical Center Nijmegen The Netherlands

Department of Nephrology AOGB Cagliari Italy

Department of Nephrology Aristotle University of Thessaloniki Thessaloniki Greece

Department of Nephrology Bambino Gesù Children's Hospital IRCCS Rome Italy

Department of Nephrology Belcolle Hospital Viterbo Italy

Department of Nephrology BFU Bari Italy

Department of Nephrology Borgomanero Italy

Department of Nephrology Careggi Hospital Florence Italy

Department of Nephrology CSST Turin Italy

Department of Nephrology Dubrava University Zagreb Croatia

Department of Nephrology Fundacion Jimenez Diaz CIBERDEM Madrid Spain

Department of Nephrology H12Octubre Madrid Spain

Department of Nephrology Hospital Maggiore di Lodi Lodi Italy

Department of Nephrology Imperial College London UK

Department of Nephrology Karolinska Institutet Stockholm Sweden

Department of Nephrology Leicester General Hospital Leicester UK

Department of Nephrology Maggiore della Carità Hospital Piem Onte Orientale University Novara Italy

Department of Nephrology Medical School University of Ioannina Ioannina Greece

Department of Nephrology OAM Lecco Italy

Department of Nephrology Puigvert Barcelona Spain

Department of Nephrology Santa Croce Hospital Cuneo Italy

Department of Nephrology Sapienza University Rome Italy

Department of Nephrology Tartu University Clinics Tartu Estonia

Department of Pediatric Nephrology Hacettepe University Faculty of Medicine Ankara Turkey

Department of Transplantation Medicine and Nephrology Medical University of Warsaw Warsaw Poland

Division of Nephrology Rheinisch Westfälische Technische Hochschule Aachen Aachen Germany

Division of Pediatrics Department of Clinical Science Intervention and Technology Huddinge Sweden

Fondazione Ricerca Molinette Turin Piemonte Italy

Glasgow Renal and Transplant Unit Queen Elizabeth University Hospital Glasgow UK

Nephrology Degli Infermi Hospital Biella Italy

Nephrology General University Hospital Prague Czech Republic

Nephrology Istanbul University Istanbul Turkey

Nephrology Regina Margherita Hospital Turin Italy

Nephrology S Anna Hospital Como Colorado Italy

Renal Department University of Uppsala Uppsala Sweden

University Toronto GH Toronto ON Canada

Citace poskytuje Crossref.org

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