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Hum Pathol. 2014 Feb;45(2):236-43. doi: 10.1016/j.humpath.2013.08.019.

Comparison of the Haas and the Oxford classifications for prediction of renal outcome in patients with IgA nephropathy.

Author information

1
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, South Korea.
2
Department of Pathology, NHIS Ilsan Hospital, Goyang-shi, Gyeonggi-do, South Korea.
3
Department of Pathology, College of Medicine, Yonsei University, Seoul, South Korea.
4
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, South Korea; Severance Biomedical Science Institute, Brain Korea 21, Yonsei University, Seoul, South Korea.
5
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, South Korea. Electronic address: yoosy0316@yuhs.ac.

Abstract

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.

KEYWORDS:

IgA nephropathy; Long-term outcome; Proteinuria

PMID:
24439222
DOI:
10.1016/j.humpath.2013.08.019
[Indexed for MEDLINE]
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