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Clinical and Experimental Nephrology

, Volume 18, Issue 3, pp 475–480 | Cite as

Overestimation of the risk of progression to end-stage renal disease in the poor prognosis’ group according to the 2002 Japanese histological classification for immunoglobulin A nephropathy

  • Yoichi Miyazaki
  • Tetsuya Kawamura
  • Kensuke Joh
  • Hideo Okonogi
  • Kentaro Koike
  • Yasunori Utsunomiya
  • Makoto Ogura
  • Masato Matsushima
  • Mitsuhiro Yoshimura
  • Satoshi Horikoshi
  • Yusuke Suzuki
  • Akira Furusu
  • Takashi Yasuda
  • Sayuri Shirai
  • Takanori Shibata
  • Masayuki Endoh
  • Motoshi Hattori
  • Yuko Akioka
  • Ritsuko Katafuti
  • Akinori Hashiguchi
  • Kenjiro Kimura
  • Seiichi Matsuo
  • Yasuhiko Tomino
Original Article

Abstract

Background

The current (2012) histological classification of immunoglobulin A nephropathy was established using a case–control study of 287 patients. However, the risk of progression to end-stage renal disease (ESRD) has not been validated for the previous (2002) classification. This study aimed to determine whether the previous classification could identify the risk of long-term renal outcome through re-analysis of the 2012 cohort.

Methods

On the basis of the 2002 classification, namely ‘good prognosis’, ‘relatively good prognosis’, ‘relatively poor prognosis’, and ‘poor prognosis’, we examined the clinical data at the time of biopsy, the correlation between the 2002 classification and long-term renal outcomes, and a patient-by-patient correlation between the 2002 and 2012 classification systems. This was performed by analyzing samples from the 287 patients used to establish the 2012 classification.

Results

The rate of decline of estimated glomerular filtration rate was greater and the odds ratio of progression to ESRD was higher in the ‘poor prognosis’ group. In contrast, the odds ratio for renal death was comparable between the groups described as ‘relatively poor prognosis’ and ‘relatively good prognosis’ in the 2002 classification. Many patients in the 2002 classification were classified with a lower histological grade in the current classification, but none were classified with a higher grade.

Conclusions

The 2002 classification could also identify the risk of progression to ESRD. However, it was overestimated for patients in the ‘poor prognosis’ group in the 2002 classification, as that group included patients with milder histological damage.

Keywords

Current histological classification IgA nephropathy classification Tuft adhesion Multicenter Case–control study EGFR decline 

Notes

Acknowledgments

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

Conflict of interest

None.

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Copyright information

© Japanese Society of Nephrology 2013

Authors and Affiliations

  • Yoichi Miyazaki
    • 1
  • Tetsuya Kawamura
    • 1
  • Kensuke Joh
    • 2
  • Hideo Okonogi
    • 1
  • Kentaro Koike
    • 1
  • Yasunori Utsunomiya
    • 1
  • Makoto Ogura
    • 1
  • Masato Matsushima
    • 3
  • Mitsuhiro Yoshimura
    • 4
  • Satoshi Horikoshi
    • 5
  • Yusuke Suzuki
    • 5
  • Akira Furusu
    • 6
  • Takashi Yasuda
    • 7
  • Sayuri Shirai
    • 7
  • Takanori Shibata
    • 8
  • Masayuki Endoh
    • 9
  • Motoshi Hattori
    • 10
  • Yuko Akioka
    • 10
  • Ritsuko Katafuti
    • 11
  • Akinori Hashiguchi
    • 12
  • Kenjiro Kimura
    • 7
  • Seiichi Matsuo
    • 13
  • Yasuhiko Tomino
    • 5
  1. 1.Division of Kidney and Hypertension, Department of Internal MedicineJikei University School of MedicineTokyoJapan
  2. 2.Department of PathologySendai Shakaihoken HospitalSendaiJapan
  3. 3.Division of Clinical Epidemiology, General Research Centre of MedicineJikei University School of MedicineTokyoJapan
  4. 4.Department of Internal MedicineKanazawa Medical CentreKanazawaJapan
  5. 5.Division of Nephrology, Department of Internal MedicineJuntendo University School of MedicineTokyoJapan
  6. 6.Second Department of Internal MedicineNagasaki University Hospital of Medicine and DentistryNagasakiJapan
  7. 7.Division of Kidney and Hypertension, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
  8. 8.Division of Nephrology, Department of MedicineShowa University School of MedicineTokyoJapan
  9. 9.Division of Nephrology and Metabolism, Department of Internal MedicineTokai University School of MedicineIseharaJapan
  10. 10.Department of Pediatric NephrologyTokyo Women’s Medical University School of MedicineTokyoJapan
  11. 11.Division of Internal MedicineNational Fukuoka-Higashi Medical CenterFukuokaJapan
  12. 12.Department of PathologyKeio University School of MedicineTokyoJapan
  13. 13.Division of Nephrology, Department of Internal Medicine, Faculty of MedicineUniversity of NagoyaNagoyaJapan

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