Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments

Rosanna Coppo, Stéphan Troyanov, Shubha Bellur, Daniel Cattran, H. Terence Cook, John Feehally, Ian S D Roberts, Laura Morando, Roberta Camilla, Vladimir Tesar, Sigrid Lunberg, Loreto Gesualdo, Francesco Emma, Cristiana Rollino, Alessandro Amore, Manuel Praga, Sandro Feriozzi, Giuseppe Segoloni, Antonello Pani, Giovanni CancariniMagalena Durlik, Elisabetta Moggia, Gianna Mazzucco, Costantinos Giannakakis, Eva Honsova, B. Brigitta Sundelin, Anna Maria Di Palma, Franco Ferrario, Eduardo Gutierrez, Anna Maria Asunis, Jonathan Barratt, Regina Tardanico, Agnieszka Perkowska-Ptasinska, D. Maixnerova, S. Lundberg, L. Fuiano, G. Beltrame, L. Peruzzi, R. Polci, L. Colla, A. Angioi, D. Piras, S. Ravera, J. Ballarin, S. Di Giulio, F. Pugliese, Y. Caliskan, F. Locatelli, L. Del Vecchio, J. F M Wetzels, H. Peters, U. Berg, F. Carvalho, M. Maggio, A. Wiecek, M. Ots-Rosenberg, R. 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, M. Quaglia, R. Bergia, R. Cravero, M. Salvadori, L. Cirami, B. Fellstrom, H. Kloster Smerud, 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, S. Savoldi, C. Licata, M. Mizerska Wasiak, G. Martina, A. Messuerotti, A. Dal Canton, C. Esposito, C. Migotto, G. Triolo, F. Mariano, C. Pozzi, R. Boero, F. Ferrario, E. Gutiérrez, J. Arce Terroba, M. Fortunato, Y. Ozluk, I. Kilicaslan, E. Steenberger, M. Soderberg, A. C. Da Costa Ferreira, Z. Riispere, L. Furci, D. Orhan, D. Kipgen, D. Casartelli, D. Galesic Ljubanovic, E. Bertoni, P. Cannata Ortiz, H. J. Groene, A. 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) identified mesangial hypercellularity (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T) as independent predictors of outcome. Whether it applies to individuals excluded from the original study and how therapy influences the predictive value of pathology remain uncertain. The VALIGA study examined 1147 patients from 13 European countries that encompassed the whole spectrum of IgAN. Over a median follow-up of 4.7 years, 86% received renin-angiotensin system blockade and 42% glucocorticoid/immunosuppressive drugs. M, S, and T lesions independently predicted the loss of estimated glomerular filtration rate (eGFR) and a lower renal survival. Their value was also assessed in patients not represented in the Oxford cohort. In individuals with eGFR less than 30 ml/min per 1.73 m 2, the M and T lesions independently predicted a poor survival. In those with proteinuria under 0.5 g/day, both M and E lesions were associated with a rise in proteinuria to 1 or 2 g/day or more. The addition of M, S, and T lesions to clinical variables significantly enhanced the ability to predict progression only in those who did not receive immunosuppression (net reclassification index 11.5%). The VALIGA study provides a validation of the Oxford classification in a large European cohort of IgAN patients across the whole spectrum of the disease. The independent predictive value of pathology MEST score is reduced by glucocorticoid/immunosuppressive therapy.

Original languageEnglish
Pages (from-to)828-836
Number of pages9
JournalKidney International
Volume86
Issue number4
DOIs
Publication statusPublished - Jan 1 2014

Keywords

  • glomerular diseases
  • IgA nephropathy
  • progression of chronic renal failure
  • proteinuria
  • renal pathology
  • risk factors

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Fingerprint Dive into the research topics of 'Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments'. Together they form a unique fingerprint.

  • Cite this

    Coppo, R., Troyanov, S., Bellur, S., Cattran, D., Cook, H. T., Feehally, J., Roberts, I. S. D., Morando, L., Camilla, R., Tesar, V., Lunberg, S., Gesualdo, L., Emma, F., Rollino, C., Amore, A., Praga, M., Feriozzi, S., Segoloni, G., Pani, A., ... Ioachim, E. (2014). Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments. Kidney International, 86(4), 828-836. https://doi.org/10.1038/ki.2014.63