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J Nephropathol. 2012 Apr;1(1):31-42. doi: 10.5812/jnp.7. Epub 2012 Apr 5.

Oxford-MEST classification in IgA nephropathy patients: A report from Iran.

Author information

1
Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan,Iran.
2
Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan , Iran.
3
Department of Nephrology, Ahvaz Jundishpur University of Medical Sciences, Ahvaz, Iran.
4
Department of Biostatistics and Epidemiology, Faculty of Health,Shahrekord University of Medical Sciences, Shahrekord, Iran.
5
Department of Pathology, Isfahan University of Medical Sciences, Isfahan , Iran.
6
Department of Nephrology, Shahrekord University of Medical Sciences, Shahrekord, Iran.
7
Medical Physics and Medical Engineering Department,Isfahan University of Medical Sciences ,Isfahan, Iran.
8
Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
9
Division of Renal Immunopathology, Dr. Baradaran Laboratory, Isfahan, Iran.
10
Department of Nephrology, Tabriz University of Medical Sciences, Tabriz , Iran.
11
Cardiovascular and Renal Research Laboratory, Memorial University of New found land, Canada.
12
Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
13
Department of Nephrology, Semnan University of Medical Sciences, Semnan, Iran.

Abstract

BACKGROUND:

There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region.

OBJECTIVES:

The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory.

PATIENTS AND METHODS:

At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system.

RESULTS:

In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females . Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001).

CONCLUSIONS:

Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease.In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system.

KEYWORDS:

Classification; Glomerulosclerosis; IgA nephropathy; Interstitial fibrosis; Proliferation; Tubular atrophy

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