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The Oxford classification of IgA nephropathy: single centre experience

Ladislava Grcevska1, Vesna Ristovska, Vladimir Nikolov

  • 1University Nephrology Department, Ss. Cyril and Methodius University, Skopje, R. Macedonia.

Prilozi
|January 25, 2011
PubMed

Insights

The Oxford classification

Area of Science:

  • Nephrology
  • Pathology
  • Glomerular Diseases

Background:

  • The Oxford classification (2009) identified four key pathological variables in IgA nephropathy.
  • These variables were proposed for predicting renal outcomes in IgA nephropathy patients.

Purpose of the Study:

  • To correlate the four Oxford classification variables with renal outcomes in adult IgA nephropathy patients.
  • To validate the predictive value of these pathological features for disease progression.

Main Methods:

  • Retrospective analysis of 40 adult IgA nephropathy patients.
  • Histopathological assessment of mesangial hypercellularity, segmental glomerulosclerosis, endocapillary hypercellularity, and tubular atrophy/interstitial fibrosis.
  • Correlation of pathological findings with clinical data and renal survival over 3-27 years.

Main Results:

  • All four Oxford classification variables showed significant association with renal outcome.
  • Mesangial hypercellularity (p=0.047), glomerular sclerosis (p=0.009), endocapillary hypercellularity (p=0.001), and tubulointerstitial changes (p=0.045) were predictive.
  • In severe disease, only tubulointerstitial changes predicted survival (p=0.018); in mild disease, segmental glomerulosclerosis was predictive.

Conclusions:

  • The four pathological variables from the Oxford classification are valuable predictors of renal outcome in IgA nephropathy.
  • The predictive significance of these variables may differ between mild and severe forms of the disease.
  • Tubulointerstitial changes are crucial for predicting survival in severe IgA nephropathy.

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