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The Japanese Histologic Classification and T-score in the Oxford Classification system could predict renal outcome in Japanese IgA nephropathy patients

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Abstract

Background

The Oxford Classification is utilized globally, but has not been fully validated. In this study, we conducted a comparative analysis between the Oxford Classification and Japanese Histologic Classification (JHC) to predict renal outcome in Japanese patients with IgA nephropathy (IgAN).

Methods

A retrospective cohort study including 86 adult IgAN patients was conducted. The Oxford Classification and the JHC were evaluated by 7 independent specialists. The JHC, MEST score in the Oxford Classification, and crescents were analyzed in association with renal outcome, defined as a 50% increase in serum creatinine.

Results

In multivariate analysis without the JHC, only the T score was significantly associated with renal outcome. While, a significant association was revealed only in the JHC on multivariate analysis with JHC.

Conclusions

The JHC and T score in the Oxford Classification were associated with renal outcome among Japanese patients with IgAN. Superiority of the JHC as a predictive index should be validated with larger study population and cohort studies in different ethnicities.

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Acknowledgements

This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Rare and Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Nephrology/CKD initiatives, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Ahmad Baseer Kaihan, Yoshinari Yasuda, Takayuki Katsuno, Sawako Kato, Takahiro Imaizumi, Takaya Ozeki, Manabu Hishida, Takanobu Nagata, Masahiko Ando, Naotake Tsuboi & Shoichi Maruyama

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  1. Ahmad Baseer Kaihan
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  2. Yoshinari Yasuda
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  3. Takayuki Katsuno
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Correspondence to Yoshinari Yasuda.

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Conflict of interest

The Department of Nephrology, Nagoya University Graduate School of Medicine received research promotion grants from Astellas, Alexion, Otsuka, Kyowa Hakko Kirin, Daiichi Sankyo, Dainippon Sumitomo, Takeda, Torii, Pfizer, and Mochida. Department of CKD Initiatives, Nagoya University Graduate School of Medicine received donation from MSD, Dainippon Sumitomo, Kyowa Hakko Kirin, Kowa, Chugai, Boehringer Ingelheim, Nihon Medi-Physics Co.,Ltd. and research promotion grants from Daiichi Sankyo, Takeda, Torii, Astellas, and Shionogi.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number 1135/2015-0386) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The ethical committee approved this retrospective cohort study without written informed consent, but informed consent was obtained from almost all study participants at the time of renal biopsy.

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Kaihan, A.B., Yasuda, Y., Katsuno, T. et al. The Japanese Histologic Classification and T-score in the Oxford Classification system could predict renal outcome in Japanese IgA nephropathy patients. Clin Exp Nephrol 21, 986–994 (2017). https://doi.org/10.1007/s10157-017-1393-x

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  • DOI: https://doi.org/10.1007/s10157-017-1393-x

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