Validation of the revised Oxford classification for IgA nephropathy considering treatment with corticosteroids/immunosuppressors

Sci Rep. 2020 Jul 7;10(1):11151. doi: 10.1038/s41598-020-68087-y.

Abstract

The Oxford classification for IgA nephropathy (IgAN) was updated in 2017. We have validated the revised Oxford classification considering treatment with corticosteroids/immunosuppressors. In this retrospective analysis, 871 IgAN patients were enrolled. Patients were divided into two groups, those treated with or without corticosteroids/immunosuppressors. The 20-year renal prognosis up to end-stage renal disease was assessed using the Oxford classification. In all patients, the renal survival rate was 87.5% at 10 years and 72.6% at 20 years. The T score alone was significantly related to renal prognosis in the Kaplan-Meier analysis and multivariate Cox regression analysis. In the non-treatment group (n = 445), E, S, T, and C scores were significantly related to renal survival rates, however, in the treatment group (n = 426), T score alone was significantly related to renal prognosis on Kaplan-Meier analysis, indicating that corticosteroids/immunosuppressors improved renal prognosis in E1, S1, and C1. In patients with E1, S1, or C1, the treatment group showed significantly better renal prognosis than the non-treatment group in univariate and multivariate analysis. The Oxford classification and T score were used to determine renal prognosis in IgAN patients. Corticosteroids/immunosuppressors improved renal prognosis, especially E1, S1, and C1 scores.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Female
  • Glomerular Filtration Rate
  • Glomerulonephritis, IGA / classification*
  • Glomerulonephritis, IGA / diagnosis
  • Glomerulonephritis, IGA / drug therapy
  • Glomerulonephritis, IGA / pathology
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kaplan-Meier Estimate
  • Kidney / pathology
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Reproducibility of Results
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents