The Oxford Classification of IgA nephropathy (IgAN) includes the following four histologic components: mesangial (M) and endocapillary (E) hypercellularity, segmental sclerosis (S) and interstitial fibrosis/tubular atrophy (T). These combine to form the MEST score and are independently associated with renal outcome. Current prediction and risk stratification in IgAN requires clinical data over 2 years of follow-up. Using modern prediction tools, we examined whether combining MEST with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than current best methods that use 2 years of follow-up data. We used a cohort of 901 adults with IgAN from the Oxford derivation and North American validation studies and the VALIGA study followed for a median of 5.6 years to analyze the primary outcome (50% decrease in eGFR or ESRD) using Cox regression models. Covariates of clinical data at biopsy (eGFR, proteinuria, MAP) with or without MEST, and then 2-year clinical data alone (2-year average of proteinuria/MAP, eGFR at biopsy) were considered. There was significant improvement in prediction by adding MEST to clinical data at biopsy. The combination predicted the outcome as well as the 2-year clinical data alone, with comparable calibration curves. This effect did not change in subgroups treated or not with RAS blockade or immunosuppression. Thus, combining the MEST score with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than our current best methods.
Barbour, S.j., Espino-Hernandez, G., Reich, H.n., Coppo, R., Roberts, I., Feehally, J., et al. (2015). The MEST score provides earlier risk prediction in IgA nephropathy. KIDNEY INTERNATIONAL, 89(1), 167-175.
|Tipologia:||Articolo su rivista|
|Citazione:||Barbour, S.j., Espino-Hernandez, G., Reich, H.n., Coppo, R., Roberts, I., Feehally, J., et al. (2015). The MEST score provides earlier risk prediction in IgA nephropathy. KIDNEY INTERNATIONAL, 89(1), 167-175.|
|Settore Scientifico Disciplinare:||Settore MED/14 - Nefrologia|
|Revisione (peer review):||Esperti anonimi|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1038/ki.2015.322|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||2015|
|Titolo:||The MEST score provides earlier risk prediction in IgA nephropathy|
|Autori:||Barbour, Sj; Espino-Hernandez, G; Reich, Hn; Coppo, R; Roberts, Isd; Feehally, J; Herzenberg, Am; Cattran, Dc|
|Appare nelle tipologie:||01 - Articolo su rivista|