The MEST score provides earlier risk prediction in lgA nephropathy

Sean J. Barbour, Gabriela Espino-Hernandez, Heather N. Reich, Rosanna Coppo, Ian S D Roberts, John Feehally, Andrew M. Herzenberg, Daniel C. Cattran, N. Bavbek, T. Cook, Stéphan Troyanov, Charles E. Alpers, A. Amore, Jonathan Barratt, Francois Berthoux, Stephen Bonsib, J. Bruijn, V. D. D'Agati, G. D'Amico, Steven Emancipator & 163 others F. Emmal, Francesca Ferrario, F. Fervenza, Sandrine Florquin, Agnes Fogo, C. Geddes, H. Groene, Mark Haas, Prue A. Hill, R. Hogg, Stephen I. Hsu, T. Hunley, M. Hladunewich, C. Jennette, Kensuke Joh, Bruce A. Julian, Tetsuya Kawamura, Fernand M. Lai, C. Leung, Lei Shi Li, P. Li, Z. H. Liu, A. Massat, Bruce MacKinnon, Sergio Mezzano, Francesco Paolo Schena, Yasuhiko Tomino, Patrick D. Walker, H. Wang, Jan J. Weening, N. Yoshikawa, H. Zhang, R. Coppo, S. Troyanov, D. C. Cattran, H. T. Cook, J. Feehally, Ian S D Roberts, Vladimir Tesar, D. Maixnerova, S. Lundberg, L. Gesualdo, Francesco Emma, L. Fuiano, G. Beltrame, Cristiana Rollino, Alessandro Amore, Roberta Camilla, L. Peruzzi, Manuel Praga, Sandro Feriozzi, R. Polci, G. Segoloni, L. Colla, Antonello Pani, A. Angioi, L. Piras, Giovanni Cancarini, S. Ravera, Magalena Durlik, Elisabetta Moggia, J. Ballarin, S. Di Giulio, F. Pugliese, I. Serriello, Y. Caliskan, M. Sever, I. Kilicaslan, F. Locatelli, Lucia Del Vecchio, J. F M Wetzels, H. Peters, U. Berg, F. Carvalho, A. C. Da Costa Ferreira, M. Maggio, A. Wiecek, M. Ots-Rosenberg, Riccardo Magistroni, R. Topaloglu, Y. Bilginer, M. D'Amico, M. Stangou, F. Giacchino, D. Goumenos, P. Kalliakmani, M. Gerolymos, K. Galesic, C. Geddes, K. Siamopoulos, O. Balafa, M. Galliani, P. Stratta, Marco Quaglia, R. Bergia, R. Cravero, M. Salvadori, L. Cirami, B. Fellstrom, H. Kloster Smerud, F. Ferrario, T. Stellato, J. Egido, C. Martin, J. Floege, F. Eitner, A. Lupo, P. Bernich, P. Menè, M. Morosetti, C. Van Kooten, T. Rabelink, M. E J Reinders, J. M. Boria Grinyo, S. Cusinato, L. Benozzi, Silvana Savoldi, C. Licata, M. Mizerska Wasiak, G. Martina, A. Messuerotti, Antonio Dal Canton, Ciro Esposito, C. Migotto, G. Triolo, F. Mariano, C. Pozzi, R. Boero, Shubha Bellur, Gianna Mazzucco, Costantinos Giannakakis, Eva Honsova, B. Brigitta Sundelin, A. M. Di Palma, Franco Ferrario, Eduardo Gutierrez, Anna Maria Asunis, Jonathan Barratt, Regina Tardanico, Agnieszka Perkowska-Ptasinska, J. Arce Terroba, M. Fortunato, A. Pantzaki, Y. Ozluk, Eric Steenbergen, M. Soderberg, Z. Riispere, Luciana Furci, D. Orhan, D. Kipgen, D. Casartelli, D. Galesic Ljubanovic, H. Gakiopoulou, E. Bertoni, P. Cannata Ortiz, H. Karkoszka, H. J. Groene, Antonella Stoppacciaro, I. Bajema, J. Bruijn, X. Fulladosa Oliveras, J. Maldyk, E. Ioachim

Research output: Contribution to journalArticle

Abstract

The Oxford Classification of IgA nephropathy (IgAN) includes the following four histologic components: mesangial (M) and endocapillary (E) hypercellularity, segmental sclerosis (S) and interstitial fibrosis/tubular atrophy (T). These combine to form the MEST score and are independently associated with renal outcome. Current prediction and risk stratification in IgAN requires clinical data over 2 years of follow-up. Using modern prediction tools, we examined whether combining MEST with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than current best methods that use 2 years of follow-up data. We used a cohort of 901 adults with IgAN from the Oxford derivation and North American validation studies and the VALIGA study followed for a median of 5.6 years to analyze the primary outcome (50% decrease in eGFR or ESRD) using Cox regression models. Covariates of clinical data at biopsy (eGFR, proteinuria, MAP) with or without MEST, and then 2-year clinical data alone (2-year average of proteinuria/MAP, eGFR at biopsy) were considered. There was significant improvement in prediction by adding MEST to clinical data at biopsy. The combination predicted the outcome as well as the 2-year clinical data alone, with comparable calibration curves. This effect did not change in subgroups treated or not with RAS blockade or immunosuppression. Thus, combining the MEST score with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than our current best methods.

Original languageEnglish
Pages (from-to)167-175
Number of pages9
JournalKidney International
Volume89
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Fingerprint

Immunoglobulin A
Biopsy
Proteinuria
Myeloma Proteins
Validation Studies
Sclerosis
Proportional Hazards Models
Immunosuppression
Calibration
Chronic Kidney Failure
Atrophy
Fibrosis
Kidney

Keywords

  • glomerular disease
  • IgA nephropathy
  • renal pathology

ASJC Scopus subject areas

  • Nephrology

Cite this

Barbour, S. J., Espino-Hernandez, G., Reich, H. N., Coppo, R., Roberts, I. S. D., Feehally, J., ... Ioachim, E. (2016). The MEST score provides earlier risk prediction in lgA nephropathy. Kidney International, 89(1), 167-175. https://doi.org/10.1038/ki.2015.322

The MEST score provides earlier risk prediction in lgA nephropathy. / Barbour, Sean J.; Espino-Hernandez, Gabriela; Reich, Heather N.; Coppo, Rosanna; Roberts, Ian S D; Feehally, John; Herzenberg, Andrew M.; Cattran, Daniel C.; Bavbek, N.; Cook, T.; Troyanov, Stéphan; Alpers, Charles E.; Amore, A.; Barratt, Jonathan; Berthoux, Francois; Bonsib, Stephen; Bruijn, J.; D'Agati, V. D.; D'Amico, G.; Emancipator, Steven; Emmal, F.; Ferrario, Francesca; Fervenza, F.; Florquin, Sandrine; Fogo, Agnes; Geddes, C.; Groene, H.; Haas, Mark; Hill, Prue A.; Hogg, R.; Hsu, Stephen I.; Hunley, T.; Hladunewich, M.; Jennette, C.; Joh, Kensuke; Julian, Bruce A.; Kawamura, Tetsuya; Lai, Fernand M.; Leung, C.; Li, Lei Shi; Li, P.; Liu, Z. H.; Massat, A.; MacKinnon, Bruce; Mezzano, Sergio; Schena, Francesco Paolo; Tomino, Yasuhiko; Walker, Patrick D.; Wang, H.; Weening, Jan J.; Yoshikawa, N.; Zhang, H.; Coppo, R.; Troyanov, S.; Cattran, D. C.; Cook, H. T.; Feehally, J.; Roberts, Ian S D; Tesar, Vladimir; Maixnerova, D.; Lundberg, S.; Gesualdo, L.; Emma, Francesco; Fuiano, L.; Beltrame, G.; Rollino, Cristiana; Amore, Alessandro; Camilla, Roberta; Peruzzi, L.; Praga, Manuel; Feriozzi, Sandro; Polci, R.; Segoloni, G.; Colla, L.; Pani, Antonello; Angioi, A.; Piras, L.; Cancarini, Giovanni; Ravera, S.; Durlik, Magalena; Moggia, Elisabetta; Ballarin, J.; Di Giulio, S.; Pugliese, F.; Serriello, I.; Caliskan, Y.; Sever, M.; Kilicaslan, I.; Locatelli, F.; Del Vecchio, Lucia; Wetzels, J. F M; Peters, H.; Berg, U.; Carvalho, F.; Da Costa Ferreira, A. C.; Maggio, M.; Wiecek, A.; Ots-Rosenberg, M.; Magistroni, Riccardo; Topaloglu, R.; Bilginer, Y.; D'Amico, M.; Stangou, M.; Giacchino, F.; Goumenos, D.; Kalliakmani, P.; Gerolymos, M.; Galesic, K.; Geddes, C.; Siamopoulos, K.; Balafa, O.; Galliani, M.; Stratta, P.; Quaglia, Marco; Bergia, R.; Cravero, R.; Salvadori, M.; Cirami, L.; Fellstrom, B.; Kloster Smerud, H.; Ferrario, F.; Stellato, T.; Egido, J.; Martin, C.; Floege, J.; Eitner, F.; Lupo, A.; Bernich, P.; Menè, P.; Morosetti, M.; Van Kooten, C.; Rabelink, T.; Reinders, M. E J; Boria Grinyo, J. M.; Cusinato, S.; Benozzi, L.; Savoldi, Silvana; Licata, C.; Mizerska Wasiak, M.; Martina, G.; Messuerotti, A.; Dal Canton, Antonio; Esposito, Ciro; Migotto, C.; Triolo, G.; Mariano, F.; Pozzi, C.; Boero, R.; Bellur, Shubha; Mazzucco, Gianna; Giannakakis, Costantinos; Honsova, Eva; Sundelin, B. Brigitta; Di Palma, A. M.; Ferrario, Franco; Gutierrez, Eduardo; Asunis, Anna Maria; Barratt, Jonathan; Tardanico, Regina; Perkowska-Ptasinska, Agnieszka; Arce Terroba, J.; Fortunato, M.; Pantzaki, A.; Ozluk, Y.; Steenbergen, Eric; Soderberg, M.; Riispere, Z.; Furci, Luciana; Orhan, D.; Kipgen, D.; Casartelli, D.; Galesic Ljubanovic, D.; Gakiopoulou, H.; Bertoni, E.; Cannata Ortiz, P.; Karkoszka, H.; Groene, H. J.; Stoppacciaro, Antonella; Bajema, I.; Bruijn, J.; Fulladosa Oliveras, X.; Maldyk, J.; Ioachim, E.

In: Kidney International, Vol. 89, No. 1, 01.01.2016, p. 167-175.

Research output: Contribution to journalArticle

Barbour, SJ, Espino-Hernandez, G, Reich, HN, Coppo, R, Roberts, ISD, Feehally, J, Herzenberg, AM, Cattran, DC, Bavbek, N, Cook, T, Troyanov, S, Alpers, CE, Amore, A, Barratt, J, Berthoux, F, Bonsib, S, Bruijn, J, D'Agati, VD, D'Amico, G, Emancipator, S, Emmal, F, Ferrario, F, Fervenza, F, Florquin, S, Fogo, A, Geddes, C, Groene, H, Haas, M, Hill, PA, Hogg, R, Hsu, SI, Hunley, T, Hladunewich, M, Jennette, C, Joh, K, Julian, BA, Kawamura, T, Lai, FM, Leung, C, Li, LS, Li, P, Liu, ZH, Massat, A, MacKinnon, B, Mezzano, S, Schena, FP, Tomino, Y, Walker, PD, Wang, H, Weening, JJ, Yoshikawa, N, Zhang, H, Coppo, R, Troyanov, S, Cattran, DC, Cook, HT, Feehally, J, Roberts, ISD, Tesar, V, Maixnerova, D, Lundberg, S, Gesualdo, L, Emma, F, Fuiano, L, Beltrame, G, Rollino, C, Amore, A, Camilla, R, Peruzzi, L, Praga, M, Feriozzi, S, Polci, R, Segoloni, G, Colla, L, Pani, A, Angioi, A, Piras, L, Cancarini, G, Ravera, S, Durlik, M, Moggia, E, Ballarin, J, Di Giulio, S, Pugliese, F, Serriello, I, Caliskan, Y, Sever, M, Kilicaslan, I, Locatelli, F, Del Vecchio, L, Wetzels, JFM, Peters, H, Berg, U, Carvalho, F, Da Costa Ferreira, AC, Maggio, M, Wiecek, A, Ots-Rosenberg, M, Magistroni, R, Topaloglu, R, Bilginer, Y, D'Amico, M, Stangou, M, Giacchino, F, Goumenos, D, Kalliakmani, P, Gerolymos, M, Galesic, K, Geddes, C, Siamopoulos, K, Balafa, O, Galliani, M, Stratta, P, Quaglia, M, Bergia, R, Cravero, R, Salvadori, M, Cirami, L, Fellstrom, B, Kloster Smerud, H, Ferrario, F, Stellato, T, Egido, J, Martin, C, Floege, J, Eitner, F, Lupo, A, Bernich, P, Menè, P, Morosetti, M, Van Kooten, C, Rabelink, T, Reinders, MEJ, Boria Grinyo, JM, Cusinato, S, Benozzi, L, Savoldi, S, Licata, C, Mizerska Wasiak, M, Martina, G, Messuerotti, A, Dal Canton, A, Esposito, C, Migotto, C, Triolo, G, Mariano, F, Pozzi, C, Boero, R, Bellur, S, Mazzucco, G, Giannakakis, C, Honsova, E, Sundelin, BB, Di Palma, AM, Ferrario, F, Gutierrez, E, Asunis, AM, Barratt, J, Tardanico, R, Perkowska-Ptasinska, A, Arce Terroba, J, Fortunato, M, Pantzaki, A, Ozluk, Y, Steenbergen, E, Soderberg, M, Riispere, Z, Furci, L, Orhan, D, Kipgen, D, Casartelli, D, Galesic Ljubanovic, D, Gakiopoulou, H, Bertoni, E, Cannata Ortiz, P, Karkoszka, H, Groene, HJ, Stoppacciaro, A, Bajema, I, Bruijn, J, Fulladosa Oliveras, X, Maldyk, J & Ioachim, E 2016, 'The MEST score provides earlier risk prediction in lgA nephropathy', Kidney International, vol. 89, no. 1, pp. 167-175. https://doi.org/10.1038/ki.2015.322
Barbour SJ, Espino-Hernandez G, Reich HN, Coppo R, Roberts ISD, Feehally J et al. The MEST score provides earlier risk prediction in lgA nephropathy. Kidney International. 2016 Jan 1;89(1):167-175. https://doi.org/10.1038/ki.2015.322
Barbour, Sean J. ; Espino-Hernandez, Gabriela ; Reich, Heather N. ; Coppo, Rosanna ; Roberts, Ian S D ; Feehally, John ; Herzenberg, Andrew M. ; Cattran, Daniel C. ; Bavbek, N. ; Cook, T. ; Troyanov, Stéphan ; Alpers, Charles E. ; Amore, A. ; Barratt, Jonathan ; Berthoux, Francois ; Bonsib, Stephen ; Bruijn, J. ; D'Agati, V. D. ; D'Amico, G. ; Emancipator, Steven ; Emmal, F. ; Ferrario, Francesca ; Fervenza, F. ; Florquin, Sandrine ; Fogo, Agnes ; Geddes, C. ; Groene, H. ; Haas, Mark ; Hill, Prue A. ; Hogg, R. ; Hsu, Stephen I. ; Hunley, T. ; Hladunewich, M. ; Jennette, C. ; Joh, Kensuke ; Julian, Bruce A. ; Kawamura, Tetsuya ; Lai, Fernand M. ; Leung, C. ; Li, Lei Shi ; Li, P. ; Liu, Z. H. ; Massat, A. ; MacKinnon, Bruce ; Mezzano, Sergio ; Schena, Francesco Paolo ; Tomino, Yasuhiko ; Walker, Patrick D. ; Wang, H. ; Weening, Jan J. ; Yoshikawa, N. ; Zhang, H. ; Coppo, R. ; Troyanov, S. ; Cattran, D. C. ; Cook, H. T. ; Feehally, J. ; Roberts, Ian S D ; Tesar, Vladimir ; Maixnerova, D. ; Lundberg, S. ; Gesualdo, L. ; Emma, Francesco ; Fuiano, L. ; Beltrame, G. ; Rollino, Cristiana ; Amore, Alessandro ; Camilla, Roberta ; Peruzzi, L. ; Praga, Manuel ; Feriozzi, Sandro ; Polci, R. ; Segoloni, G. ; Colla, L. ; Pani, Antonello ; Angioi, A. ; Piras, L. ; Cancarini, Giovanni ; Ravera, S. ; Durlik, Magalena ; Moggia, Elisabetta ; Ballarin, J. ; Di Giulio, S. ; Pugliese, F. ; Serriello, I. ; Caliskan, Y. ; Sever, M. ; Kilicaslan, I. ; Locatelli, F. ; Del Vecchio, Lucia ; Wetzels, J. F M ; Peters, H. ; Berg, U. ; Carvalho, F. ; Da Costa Ferreira, A. C. ; Maggio, M. ; Wiecek, A. ; Ots-Rosenberg, M. ; Magistroni, Riccardo ; Topaloglu, R. ; Bilginer, Y. ; D'Amico, M. ; Stangou, M. ; Giacchino, F. ; Goumenos, D. ; Kalliakmani, P. ; Gerolymos, M. ; Galesic, K. ; Geddes, C. ; Siamopoulos, K. ; Balafa, O. ; Galliani, M. ; Stratta, P. ; Quaglia, Marco ; Bergia, R. ; Cravero, R. ; Salvadori, M. ; Cirami, L. ; Fellstrom, B. ; Kloster Smerud, H. ; Ferrario, F. ; Stellato, T. ; Egido, J. ; Martin, C. ; Floege, J. ; Eitner, F. ; Lupo, A. ; Bernich, P. ; Menè, P. ; Morosetti, M. ; Van Kooten, C. ; Rabelink, T. ; Reinders, M. E J ; Boria Grinyo, J. M. ; Cusinato, S. ; Benozzi, L. ; Savoldi, Silvana ; Licata, C. ; Mizerska Wasiak, M. ; Martina, G. ; Messuerotti, A. ; Dal Canton, Antonio ; Esposito, Ciro ; Migotto, C. ; Triolo, G. ; Mariano, F. ; Pozzi, C. ; Boero, R. ; Bellur, Shubha ; Mazzucco, Gianna ; Giannakakis, Costantinos ; Honsova, Eva ; Sundelin, B. Brigitta ; Di Palma, A. M. ; Ferrario, Franco ; Gutierrez, Eduardo ; Asunis, Anna Maria ; Barratt, Jonathan ; Tardanico, Regina ; Perkowska-Ptasinska, Agnieszka ; Arce Terroba, J. ; Fortunato, M. ; Pantzaki, A. ; Ozluk, Y. ; Steenbergen, Eric ; Soderberg, M. ; Riispere, Z. ; Furci, Luciana ; Orhan, D. ; Kipgen, D. ; Casartelli, D. ; Galesic Ljubanovic, D. ; Gakiopoulou, H. ; Bertoni, E. ; Cannata Ortiz, P. ; Karkoszka, H. ; Groene, H. J. ; Stoppacciaro, Antonella ; Bajema, I. ; Bruijn, J. ; Fulladosa Oliveras, X. ; Maldyk, J. ; Ioachim, E. / The MEST score provides earlier risk prediction in lgA nephropathy. In: Kidney International. 2016 ; Vol. 89, No. 1. pp. 167-175.
@article{a5cc747d9bba4137b0e561e826855fbc,
title = "The MEST score provides earlier risk prediction in lgA nephropathy",
abstract = "The Oxford Classification of IgA nephropathy (IgAN) includes the following four histologic components: mesangial (M) and endocapillary (E) hypercellularity, segmental sclerosis (S) and interstitial fibrosis/tubular atrophy (T). These combine to form the MEST score and are independently associated with renal outcome. Current prediction and risk stratification in IgAN requires clinical data over 2 years of follow-up. Using modern prediction tools, we examined whether combining MEST with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than current best methods that use 2 years of follow-up data. We used a cohort of 901 adults with IgAN from the Oxford derivation and North American validation studies and the VALIGA study followed for a median of 5.6 years to analyze the primary outcome (50{\%} decrease in eGFR or ESRD) using Cox regression models. Covariates of clinical data at biopsy (eGFR, proteinuria, MAP) with or without MEST, and then 2-year clinical data alone (2-year average of proteinuria/MAP, eGFR at biopsy) were considered. There was significant improvement in prediction by adding MEST to clinical data at biopsy. The combination predicted the outcome as well as the 2-year clinical data alone, with comparable calibration curves. This effect did not change in subgroups treated or not with RAS blockade or immunosuppression. Thus, combining the MEST score with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than our current best methods.",
keywords = "glomerular disease, IgA nephropathy, renal pathology",
author = "Barbour, {Sean J.} and Gabriela Espino-Hernandez and Reich, {Heather N.} and Rosanna Coppo and Roberts, {Ian S D} and John Feehally and Herzenberg, {Andrew M.} and Cattran, {Daniel C.} and N. Bavbek and T. Cook and St{\'e}phan Troyanov and Alpers, {Charles E.} and A. Amore and Jonathan Barratt and Francois Berthoux and Stephen Bonsib and J. Bruijn and D'Agati, {V. D.} and G. D'Amico and Steven Emancipator and F. Emmal and Francesca Ferrario and F. Fervenza and Sandrine Florquin and Agnes Fogo and C. Geddes and H. Groene and Mark Haas and Hill, {Prue A.} and R. Hogg and Hsu, {Stephen I.} and T. Hunley and M. Hladunewich and C. Jennette and Kensuke Joh and Julian, {Bruce A.} and Tetsuya Kawamura and Lai, {Fernand M.} and C. Leung and Li, {Lei Shi} and P. Li and Liu, {Z. H.} and A. Massat and Bruce MacKinnon and Sergio Mezzano and Schena, {Francesco Paolo} and Yasuhiko Tomino and Walker, {Patrick D.} and H. Wang and Weening, {Jan J.} and N. Yoshikawa and H. Zhang and R. Coppo and S. Troyanov and Cattran, {D. C.} and Cook, {H. T.} and J. Feehally and Roberts, {Ian S D} and Vladimir Tesar and D. Maixnerova and S. Lundberg and L. Gesualdo and Francesco Emma and L. Fuiano and G. Beltrame and Cristiana Rollino and Alessandro Amore and Roberta Camilla and L. Peruzzi and Manuel Praga and Sandro Feriozzi and R. Polci and G. Segoloni and L. Colla and Antonello Pani and A. Angioi and L. Piras and Giovanni Cancarini and S. Ravera and Magalena Durlik and Elisabetta Moggia and J. Ballarin and {Di Giulio}, S. and F. Pugliese and I. Serriello and Y. Caliskan and M. Sever and I. Kilicaslan and F. Locatelli and {Del Vecchio}, Lucia and Wetzels, {J. F M} and H. Peters and U. Berg and F. Carvalho and {Da Costa Ferreira}, {A. C.} and M. Maggio and A. Wiecek and M. Ots-Rosenberg and Riccardo Magistroni and R. Topaloglu and Y. Bilginer and M. D'Amico and M. Stangou and F. Giacchino and D. Goumenos and P. Kalliakmani and M. Gerolymos and K. Galesic and C. Geddes and K. Siamopoulos and O. Balafa and M. Galliani and P. Stratta and Marco Quaglia and R. Bergia and R. Cravero and M. Salvadori and L. Cirami and B. Fellstrom and {Kloster Smerud}, H. and F. Ferrario and T. Stellato and J. Egido and C. Martin and J. Floege and F. Eitner and A. Lupo and P. Bernich and P. Men{\`e} and M. Morosetti and {Van Kooten}, C. and T. Rabelink and Reinders, {M. E J} and {Boria Grinyo}, {J. M.} and S. Cusinato and L. Benozzi and Silvana Savoldi and C. Licata and {Mizerska Wasiak}, M. and G. Martina and A. Messuerotti and {Dal Canton}, Antonio and Ciro Esposito and C. Migotto and G. Triolo and F. Mariano and C. Pozzi and R. Boero and Shubha Bellur and Gianna Mazzucco and Costantinos Giannakakis and Eva Honsova and Sundelin, {B. Brigitta} and {Di Palma}, {A. M.} and Franco Ferrario and Eduardo Gutierrez and Asunis, {Anna Maria} and Jonathan Barratt and Regina Tardanico and Agnieszka Perkowska-Ptasinska and {Arce Terroba}, J. and M. Fortunato and A. Pantzaki and Y. Ozluk and Eric Steenbergen and M. Soderberg and Z. Riispere and Luciana Furci and D. Orhan and D. Kipgen and D. Casartelli and {Galesic Ljubanovic}, D. and H. Gakiopoulou and E. Bertoni and {Cannata Ortiz}, P. and H. Karkoszka and Groene, {H. J.} and Antonella Stoppacciaro and I. Bajema and J. Bruijn and {Fulladosa Oliveras}, X. and J. Maldyk and E. Ioachim",
year = "2016",
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doi = "10.1038/ki.2015.322",
language = "English",
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pages = "167--175",
journal = "Kidney International",
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TY - JOUR

T1 - The MEST score provides earlier risk prediction in lgA nephropathy

AU - Barbour, Sean J.

AU - Espino-Hernandez, Gabriela

AU - Reich, Heather N.

AU - Coppo, Rosanna

AU - Roberts, Ian S D

AU - Feehally, John

AU - Herzenberg, Andrew M.

AU - Cattran, Daniel C.

AU - Bavbek, N.

AU - Cook, T.

AU - Troyanov, Stéphan

AU - Alpers, Charles E.

AU - Amore, A.

AU - Barratt, Jonathan

AU - Berthoux, Francois

AU - Bonsib, Stephen

AU - Bruijn, J.

AU - D'Agati, V. D.

AU - D'Amico, G.

AU - Emancipator, Steven

AU - Emmal, F.

AU - Ferrario, Francesca

AU - Fervenza, F.

AU - Florquin, Sandrine

AU - Fogo, Agnes

AU - Geddes, C.

AU - Groene, H.

AU - Haas, Mark

AU - Hill, Prue A.

AU - Hogg, R.

AU - Hsu, Stephen I.

AU - Hunley, T.

AU - Hladunewich, M.

AU - Jennette, C.

AU - Joh, Kensuke

AU - Julian, Bruce A.

AU - Kawamura, Tetsuya

AU - Lai, Fernand M.

AU - Leung, C.

AU - Li, Lei Shi

AU - Li, P.

AU - Liu, Z. H.

AU - Massat, A.

AU - MacKinnon, Bruce

AU - Mezzano, Sergio

AU - Schena, Francesco Paolo

AU - Tomino, Yasuhiko

AU - Walker, Patrick D.

AU - Wang, H.

AU - Weening, Jan J.

AU - Yoshikawa, N.

AU - Zhang, H.

AU - Coppo, R.

AU - Troyanov, S.

AU - Cattran, D. C.

AU - Cook, H. T.

AU - Feehally, J.

AU - Roberts, Ian S D

AU - Tesar, Vladimir

AU - Maixnerova, D.

AU - Lundberg, S.

AU - Gesualdo, L.

AU - Emma, Francesco

AU - Fuiano, L.

AU - Beltrame, G.

AU - Rollino, Cristiana

AU - Amore, Alessandro

AU - Camilla, Roberta

AU - Peruzzi, L.

AU - Praga, Manuel

AU - Feriozzi, Sandro

AU - Polci, R.

AU - Segoloni, G.

AU - Colla, L.

AU - Pani, Antonello

AU - Angioi, A.

AU - Piras, L.

AU - Cancarini, Giovanni

AU - Ravera, S.

AU - Durlik, Magalena

AU - Moggia, Elisabetta

AU - Ballarin, J.

AU - Di Giulio, S.

AU - Pugliese, F.

AU - Serriello, I.

AU - Caliskan, Y.

AU - Sever, M.

AU - Kilicaslan, I.

AU - Locatelli, F.

AU - Del Vecchio, Lucia

AU - Wetzels, J. F M

AU - Peters, H.

AU - Berg, U.

AU - Carvalho, F.

AU - Da Costa Ferreira, A. C.

AU - Maggio, M.

AU - Wiecek, A.

AU - Ots-Rosenberg, M.

AU - Magistroni, Riccardo

AU - Topaloglu, R.

AU - Bilginer, Y.

AU - D'Amico, M.

AU - Stangou, M.

AU - Giacchino, F.

AU - Goumenos, D.

AU - Kalliakmani, P.

AU - Gerolymos, M.

AU - Galesic, K.

AU - Geddes, C.

AU - Siamopoulos, K.

AU - Balafa, O.

AU - Galliani, M.

AU - Stratta, P.

AU - Quaglia, Marco

AU - Bergia, R.

AU - Cravero, R.

AU - Salvadori, M.

AU - Cirami, L.

AU - Fellstrom, B.

AU - Kloster Smerud, H.

AU - Ferrario, F.

AU - Stellato, T.

AU - Egido, J.

AU - Martin, C.

AU - Floege, J.

AU - Eitner, F.

AU - Lupo, A.

AU - Bernich, P.

AU - Menè, P.

AU - Morosetti, M.

AU - Van Kooten, C.

AU - Rabelink, T.

AU - Reinders, M. E J

AU - Boria Grinyo, J. M.

AU - Cusinato, S.

AU - Benozzi, L.

AU - Savoldi, Silvana

AU - Licata, C.

AU - Mizerska Wasiak, M.

AU - Martina, G.

AU - Messuerotti, A.

AU - Dal Canton, Antonio

AU - Esposito, Ciro

AU - Migotto, C.

AU - Triolo, G.

AU - Mariano, F.

AU - Pozzi, C.

AU - Boero, R.

AU - Bellur, Shubha

AU - Mazzucco, Gianna

AU - Giannakakis, Costantinos

AU - Honsova, Eva

AU - Sundelin, B. Brigitta

AU - Di Palma, A. M.

AU - Ferrario, Franco

AU - Gutierrez, Eduardo

AU - Asunis, Anna Maria

AU - Barratt, Jonathan

AU - Tardanico, Regina

AU - Perkowska-Ptasinska, Agnieszka

AU - Arce Terroba, J.

AU - Fortunato, M.

AU - Pantzaki, A.

AU - Ozluk, Y.

AU - Steenbergen, Eric

AU - Soderberg, M.

AU - Riispere, Z.

AU - Furci, Luciana

AU - Orhan, D.

AU - Kipgen, D.

AU - Casartelli, D.

AU - Galesic Ljubanovic, D.

AU - Gakiopoulou, H.

AU - Bertoni, E.

AU - Cannata Ortiz, P.

AU - Karkoszka, H.

AU - Groene, H. J.

AU - Stoppacciaro, Antonella

AU - Bajema, I.

AU - Bruijn, J.

AU - Fulladosa Oliveras, X.

AU - Maldyk, J.

AU - Ioachim, E.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - The Oxford Classification of IgA nephropathy (IgAN) includes the following four histologic components: mesangial (M) and endocapillary (E) hypercellularity, segmental sclerosis (S) and interstitial fibrosis/tubular atrophy (T). These combine to form the MEST score and are independently associated with renal outcome. Current prediction and risk stratification in IgAN requires clinical data over 2 years of follow-up. Using modern prediction tools, we examined whether combining MEST with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than current best methods that use 2 years of follow-up data. We used a cohort of 901 adults with IgAN from the Oxford derivation and North American validation studies and the VALIGA study followed for a median of 5.6 years to analyze the primary outcome (50% decrease in eGFR or ESRD) using Cox regression models. Covariates of clinical data at biopsy (eGFR, proteinuria, MAP) with or without MEST, and then 2-year clinical data alone (2-year average of proteinuria/MAP, eGFR at biopsy) were considered. There was significant improvement in prediction by adding MEST to clinical data at biopsy. The combination predicted the outcome as well as the 2-year clinical data alone, with comparable calibration curves. This effect did not change in subgroups treated or not with RAS blockade or immunosuppression. Thus, combining the MEST score with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than our current best methods.

AB - The Oxford Classification of IgA nephropathy (IgAN) includes the following four histologic components: mesangial (M) and endocapillary (E) hypercellularity, segmental sclerosis (S) and interstitial fibrosis/tubular atrophy (T). These combine to form the MEST score and are independently associated with renal outcome. Current prediction and risk stratification in IgAN requires clinical data over 2 years of follow-up. Using modern prediction tools, we examined whether combining MEST with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than current best methods that use 2 years of follow-up data. We used a cohort of 901 adults with IgAN from the Oxford derivation and North American validation studies and the VALIGA study followed for a median of 5.6 years to analyze the primary outcome (50% decrease in eGFR or ESRD) using Cox regression models. Covariates of clinical data at biopsy (eGFR, proteinuria, MAP) with or without MEST, and then 2-year clinical data alone (2-year average of proteinuria/MAP, eGFR at biopsy) were considered. There was significant improvement in prediction by adding MEST to clinical data at biopsy. The combination predicted the outcome as well as the 2-year clinical data alone, with comparable calibration curves. This effect did not change in subgroups treated or not with RAS blockade or immunosuppression. Thus, combining the MEST score with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than our current best methods.

KW - glomerular disease

KW - IgA nephropathy

KW - renal pathology

UR - http://www.scopus.com/inward/record.url?scp=84945559550&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945559550&partnerID=8YFLogxK

U2 - 10.1038/ki.2015.322

DO - 10.1038/ki.2015.322

M3 - Article

VL - 89

SP - 167

EP - 175

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 1

ER -