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Abstract: TH-PO1037

Clinical Impact of Endocapillary Proliferation with Modified Cutoff Point in IgA Nephropathy Patients

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Kaihan, Ahmad Baseer, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
  • Yasuda, Yoshinari, Nagoya University Graduate School of Medicine, Nagoya, Aichi-ken, Japan, Nagoya, Japan
  • Imaizumi, Takahiro, Nagoya University Graduate School of Medicine, Nagoya, Aichi-ken, Japan, Nagoya, Japan
  • Hishida, Manabu, Nagoya University, Nagoya city, Japan
  • Tsuboi, Naotake, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan
Background

Predictive values of mesangial proliferation (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), and crescents (C) among 19-validation studies of Oxford Classification were discrepant, in particular among Asian IgA nephropathy (IgAN) patients. These validation studies indicate that cutoff points of MESC score in the Oxford Classification may not be generalizable. Thus, we aimed to improve clinical value of MESC scores by modifying cutoff points.

Methods

A total of 104 IgAN diagnosed from 2001 to 2012 by renal biopsy, and retrospectively evaluated at Nagoya University Hospital. Cutoff point for modified (M′E′S′C′) was determined by receiver operating characteristic curve in association with renal outcome in the training cohort. Clinical value of the Oxford MESTC vs M′E′S′C′ cutoff points were analyzed by Kaplan-Meier and Cox regression for renal outcome in the validation and all cohort.

Results

Of 104 participants 12.5% of them reached renal outcome over 6.25 [4.16-9.61] years of follow-up. The modified cutoffs were defined ≥40%, ≥10%, ≥20%, and ≥5% in glomeruli for M′E′S′C′ respectively. In univariate analysis, E′, S′, and T were significantly associated with renal outcome. Whereas, the Oxford MESC, M′, and C′ in the training and validation cohort demonstrated no significant association with renal outcome. By multivariate analysis in the presence of eGFR, only E′ was a significant predictive factor for renal outcome.

Conclusion

The E′ with modified cutoff point of 10% significantly improved predictive value for renal outcome in IgAN. Clinical value of modified cutoff points for M′E′S′C′ scores should be validated with various cohort studies in different regions.