Abstract: PO1401
Renal Outcome Using New Chronicity Scoring System in IgA Nephropathy: Nationwide Study in Korea
Session Information
- Glomerular Diseases: Fibrosis and Extracellular Matrix
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1201 Glomerular Diseases: Fibrosis and Extracellular Matrix
Authors
- Kang, Donghyuk, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
- Ban, Tae Hyun, Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
- Kim, Hyung Duk, Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)
- Choi, Bumsoon, Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)
Group or Team Name
- KOGNET group
Background
Many new grading systems of glomerulonephritis were proposed, recently. In 2019, new suggestion about standardized classification and reporting of GN is proposed by Mayo Clinic/Renal pathology society. Among the part of this new suggestion, grading the chronicity is an extremely important step and simple scoring system for chronic changes was devised. Therefore, the purpose of this study is predicting renal outcome with new chronicity grading system in IgA nephropathy (IgAN) patients.
Methods
4,505 IgAN patients were enrolled from Korean GlomeruloNephritis Study Group (KoGNET) registry. Validation of Oxford classification, chronicity index with renal survival (End stage renal disease (ESRD), eGFR decrease rate of 50%, rate of renal function decline) were evaluated, followed by subgroup analysis according to chronic kidney disease (CKD) stages. Additional analysis between immunosuppressive therapy (IST) and chronicity index was performed, that chronicity index might help deciding initiation of IST.
Results
In validation of Oxford classification, both S and T scores were significantly associated with renal outcomes, but M and C scores were not. Multivariate linear regression analysis showed chronicity index was significantly associated with renal outcomes (P<0.05 for all). The severity of chronicity index was well correlated with renal outcomes in multivariate Cox regression analysis: minimal vs mild (HR, 1.95; 95% CI, 1.15 to 3.32; P=0.014), minimal vs moderate (HR, 2.98; 95% CI, 1.66 to 5.34; P<0.001), minimal vs severe (HR, 4.08; 95% CI, 2.27 to 7.35; P<0.001). Hypertension, eGFR, proteinuria and serum uric acid were also well correlated. In subgroup analysis, chronicity index was still most powerful risk factor (P<0.05 for all) and they showed similar results to whole CKD stages. There was insufficient evidence to initiate IST according to chronicity index.
Conclusion
Among the known prognostic factors of IgAN, pathologic features were relatively abstract compared to other prognostic factors. But the chronicity index, presented as a simple integrated numeric scale, which is independently associated with renal outcome in IgAN, is more easily applicable in estimating renal outcome of IgAN patients.