Comparison of the Haas and the Oxford classifications for prediction of renal outcome in patients with IgA nephropathy
- Authors
- Park, Kyoung Sook; Han, Seung Hyeok; Kie, Jeong Hae; Nam, Ki Heon; Lee, Mi Jung; Lim, Beom Jin; Kwon, Young Eun; Kim, Yung Ly; An, Seong Yeong; Kim, Chan Ho; Doh, Fa Mee; Koo, Hyang Mo; Oh, Hyung Jung; Kang, Shin-Wook; Choi, Kyu Hun; Choi, Kyu Hun; Yoo, Tae-Hyun
- Issue Date
- Feb-2014
- Publisher
- W B SAUNDERS CO-ELSEVIER INC
- Keywords
- Proteinuria; IgA nephropathy; Long-term outcome
- Citation
- HUMAN PATHOLOGY, v.45, no.2, pp.236 - 243
- Indexed
- SCIE
SCOPUS
- Journal Title
- HUMAN PATHOLOGY
- Volume
- 45
- Number
- 2
- Start Page
- 236
- End Page
- 243
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/160624
- DOI
- 10.1016/j.humpath.2013.08.019
- ISSN
- 0046-8177
- Abstract
- Pathologic features can provide valuable information for determining prognosis in IgA nephropathy (IgAN). However, it is uncertain whether the Oxford classification, a new classification of IgAN, can predict renal outcome better than previous ones. We conducted a retrospective cohort study in 500 patients with biopsy-proven IgAN between January 2002 and December 2010 to compare the ability of the Haas and the Oxford classifications to predict renal outcome. Primary outcome was a doubling of the baseline serum creatinine concentration (D-SCr). During a mean follow-up of 68 months, 52(10.4%) and 35 (7.0%) developed D-SCr and end-stage renal disease, respectively. There were graded increases in the development of D-SCr in the higher Haas classes. In addition, the primary endpoint of D-SCr occurred more in patients with the Oxford M and T lesions than those without such lesions. In multivariate Cox regression analyses, the Haas class V (HR, 12.19; P = .002) and the Oxford T1 (hazard ratio [HR], 6.68; P < .001) and T2 (HR, 12.16; P < .001) lesions were independently associated with an increased risk of reaching D-SCr. Harrell's C index of each multivariate model with the Haas and the Oxford classification was 0.867 (P = .015) and 0.881 (P = .004), respectively. This was significantly higher than that of model with clinical factors only (C = 0.819). However, there was no difference in C-statistics between the 2 models with the Haas and the Oxford classifications (P = .348). This study suggests that the Haas and the Oxford classifications are comparable in predicting progression of IgAN.
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