Korean J Intern Med.  2012 Sep;27(3):293-300. 10.3904/kjim.2012.27.3.293.

Validation of the Oxford Classification of IgA Nephropathy: A Single-Center Study in Korean Adults

• Lee H
• Yi SH
• Seo MS
• Hyun JN
• Jeon JS
• Noh H
• Han DC
• Hwang SD
• Jin SY
• Kwon SH

• KMID: 1776521
• DOI: http://doi.org/10.3904/kjim.2012.27.3.293

Abstract

BACKGROUND/AIMS
The recently published Oxford classification of IgA nephropathy (IgAN) proposed a split system for histological grading, based on prognostic pathological features. This new classification system must be validated in a variety of cohorts. We investigated whether these pathological features were applicable to an adult Korean population.
METHODS
In total, 69 adult Korean patients with IgAN were analyzed using the Oxford classification system at Soonchunhyang University Hospital, Seoul, Korea. All cases were categorized according to Lee's classification. Renal biopsies from all patients were scored by a pathologist who was blinded to the clinical data for pathological variables. Inclusion criteria were age greater than 18 years and at least 36 months of follow-up. We excluded cases with secondary IgAN, diabetic nephropathy combined other glomerulopathies, less than 36 months of follow-up, and those that progressed rapidly.
RESULTS
The median age of the patients was 34 years (range, 27 to 45). Mean arterial blood pressure was 97 +/- 10 mmHg at the time of biopsy. The median follow-up period was 85 months (range, 60 to 114). Kaplan-Meier analysis showed significant prognostic predictions for M, E, and T lesions. A Cox proportional hazard regression analysis also revealed prognostic predictions for E and T lesions.
CONCLUSIONS
Using the Oxford classification in IgAN, E, and T lesions predicted renal outcome in Korean adults after taking clinical variables into account.

Keyword

Histology; Prognosis; Glomerulonephritis; IgA

MeSH Terms

Adult
*Asian Continental Ancestry Group
Biopsy
Chi-Square Distribution
Disease Progression
Female
Fish Oils/therapeutic use
Glomerulonephritis, IGA/classification/*diagnosis/ethnology/pathology/therapy
Hospitals, University
Humans
Immunosuppressive Agents/therapeutic use
Kaplan-Meier Estimate
Kidney/*pathology
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Reproducibility of Results
Republic of Korea/epidemiology
Retrospective Studies
Severity of Illness Index
Time Factors