PMID- 24694989 OWN - NLM STAT- MEDLINE DCOM- 20150701 LR - 20220409 IS - 1523-1755 (Electronic) IS - 0085-2538 (Print) IS - 0085-2538 (Linking) VI - 86 IP - 4 DP - 2014 Oct TI - Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments. PG - 828-36 LID - 10.1038/ki.2014.63 [doi] AB - The Oxford Classification of IgA Nephropathy (IgAN) identified mesangial hypercellularity (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T) as independent predictors of outcome. Whether it applies to individuals excluded from the original study and how therapy influences the predictive value of pathology remain uncertain. The VALIGA study examined 1147 patients from 13 European countries that encompassed the whole spectrum of IgAN. Over a median follow-up of 4.7 years, 86% received renin-angiotensin system blockade and 42% glucocorticoid/immunosuppressive drugs. M, S, and T lesions independently predicted the loss of estimated glomerular filtration rate (eGFR) and a lower renal survival. Their value was also assessed in patients not represented in the Oxford cohort. In individuals with eGFR less than 30 ml/min per 1.73 m(2), the M and T lesions independently predicted a poor survival. In those with proteinuria under 0.5 g/day, both M and E lesions were associated with a rise in proteinuria to 1 or 2 g/day or more. The addition of M, S, and T lesions to clinical variables significantly enhanced the ability to predict progression only in those who did not receive immunosuppression (net reclassification index 11.5%). The VALIGA study provides a validation of the Oxford classification in a large European cohort of IgAN patients across the whole spectrum of the disease. The independent predictive value of pathology MEST score is reduced by glucocorticoid/immunosuppressive therapy. FAU - Coppo, Rosanna AU - Coppo R AD - City of the Health and the Science of Turin Health Agency, Regina Margherita Children's Hospital, Turin, Italy. FAU - Troyanov, Stephan AU - Troyanov S AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. FAU - Bellur, Shubha AU - Bellur S AD - Oxford University Hospitals, Oxford, UK. FAU - Cattran, Daniel AU - Cattran D AD - Unversity Health Network, Toronto General Hospital, Toronto, Canada. FAU - Cook, H Terence AU - Cook HT AD - Imperial College, Hammersmith Hospital, London, UK. FAU - Feehally, John AU - Feehally J AD - University Hospitals of Leicester, Leicester, UK. FAU - Roberts, Ian S D AU - Roberts IS AD - Oxford University Hospitals, Oxford, UK. FAU - Morando, Laura AU - Morando L FAU - Camilla, Roberta AU - Camilla R FAU - Tesar, Vladimir AU - Tesar V FAU - Lunberg, Sigrid AU - Lunberg S FAU - Gesualdo, Loreto AU - Gesualdo L FAU - Emma, Francesco AU - Emma F FAU - Rollino, Cristiana AU - Rollino C FAU - Amore, Alessandro AU - Amore A FAU - Praga, Manuel AU - Praga M FAU - Feriozzi, Sandro AU - Feriozzi S FAU - Segoloni, Giuseppe AU - Segoloni G FAU - Pani, Antonello AU - Pani A FAU - Cancarini, Giovanni AU - Cancarini G FAU - Durlik, Magalena AU - Durlik M FAU - Moggia, Elisabetta AU - Moggia E FAU - Mazzucco, Gianna AU - Mazzucco G FAU - Giannakakis, Costantinos AU - Giannakakis C FAU - Honsova, Eva AU - Honsova E FAU - Sundelin, B Brigitta AU - Sundelin BB FAU - Di Palma, Anna Maria AU - Di Palma AM FAU - Ferrario, Franco AU - Ferrario F FAU - Gutierrez, Eduardo AU - Gutierrez E FAU - Asunis, Anna Maria AU - Asunis AM FAU - Barratt, Jonathan AU - Barratt J FAU - Tardanico, Regina AU - Tardanico R FAU - Perkowska-Ptasinska, Agnieszka AU - Perkowska-Ptasinska A CN - VALIGA study of the ERA-EDTA Immunonephrology Working Group LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20140402 PL - United States TA - Kidney Int JT - Kidney international JID - 0323470 RN - 0 (Immunosuppressive Agents) SB - IM CIN - Kidney Int. 2014 Nov;86(5):1062. PMID: 25360505 CIN - Kidney Int. 2015 Mar;87(3):661-2. PMID: 25723637 CIN - Kidney Int. 2015 Mar;87(3):662-3. PMID: 25723639 MH - Adolescent MH - Adult MH - Atrophy MH - Child MH - Disease Progression MH - Europe MH - Female MH - Fibrosis MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Glomerular Mesangium/pathology MH - Glomerulonephritis, IGA/*classification/drug therapy/*pathology MH - Glomerulosclerosis, Focal Segmental/pathology MH - Humans MH - Immunosuppressive Agents/therapeutic use MH - Kidney/blood supply/*pathology MH - Kidney Failure, Chronic/*pathology/physiopathology MH - Kidney Tubules/pathology MH - Male MH - Middle Aged MH - Neovascularization, Pathologic/pathology MH - Predictive Value of Tests MH - Proteinuria/pathology MH - Renin-Angiotensin System/drug effects MH - Retrospective Studies MH - Young Adult PMC - PMC4184028 FIR - Tesar, V IR - Tesar V FIR - Maixnerova, D IR - Maixnerova D FIR - Lundberg, S IR - Lundberg S FIR - Gesualdo, L IR - Gesualdo L FIR - Fuiano, L IR - Fuiano L FIR - Beltrame, G IR - Beltrame G FIR - Rollino, C IR - Rollino C FIR - Coppo, R IR - Coppo R FIR - Amore, A IR - Amore A FIR - Camilla, R IR - Camilla R FIR - Peruzzi, L IR - Peruzzi L FIR - Praga, M IR - Praga M FIR - Feriozzi, S IR - Feriozzi S FIR - Polci, R IR - Polci R FIR - Segoloni, G IR - Segoloni G FIR - Colla, L IR - Colla L FIR - Pani, A IR - Pani A FIR - Angioi, A IR - Angioi A FIR - Piras, D IR - Piras D FIR - Feehally, J IR - Feehally J FIR - Cancarini, G IR - Cancarini G FIR - Ravera, S IR - Ravera S FIR - Durlik, M IR - Durlik M FIR - Moggia, E IR - Moggia E FIR - Ballarin, J IR - Ballarin J FIR - Di Giulio, S IR - Di Giulio S FIR - Pugliese, F IR - Pugliese F FIR - Caliskan, Y IR - Caliskan Y FIR - Locatelli, F IR - Locatelli F FIR - Del Vecchio, L IR - Del Vecchio L FIR - Wetzels, J F M IR - Wetzels JF FIR - Peters, H IR - Peters H FIR - Berg, U IR - Berg U FIR - Carvalho, F IR - Carvalho F FIR - Maggio, M IR - Maggio M FIR - Wiecek, A IR - Wiecek A FIR - Ots-Rosenberg, M IR - Ots-Rosenberg M FIR - Magistroni, R IR - Magistroni R FIR - Topaloglu, R IR - Topaloglu R FIR - Bilginer, Y IR - Bilginer Y FIR - D'Amico, M IR - D'Amico M FIR - Stangou, M IR - Stangou M FIR - Giacchino, F IR - Giacchino F FIR - Goumenos, D IR - Goumenos D FIR - Kalliakmani, P IR - Kalliakmani P FIR - Gerolymos, M IR - Gerolymos M FIR - Galesic, K IR - Galesic K FIR - Geddes, C IR - Geddes C FIR - Siamopoulos, K IR - Siamopoulos K FIR - Balafa, O IR - Balafa O FIR - Galliani, M IR - Galliani M FIR - Stratta, P IR - Stratta P FIR - Quaglia, M IR - Quaglia M FIR - Bergia, R IR - Bergia R FIR - Cravero, R IR - Cravero R FIR - Salvadori, M IR - Salvadori M FIR - Cirami, L IR - Cirami L FIR - Fellstrom, B IR - Fellstrom B FIR - Kloster Smerud, H IR - Kloster Smerud H FIR - Ferrario, F IR - Ferrario F FIR - Stellato, T IR - Stellato T FIR - Egido, J IR - Egido J FIR - Martin, C IR - Martin C FIR - Floege, J IR - Floege J FIR - Eitner, F IR - Eitner F FIR - Lupo, A IR - Lupo A FIR - Bernich, P IR - Bernich P FIR - Mene, P IR - Mene P FIR - Morosetti, M IR - Morosetti M FIR - van Kooten, C IR - van Kooten C FIR - Rabelink, T IR - Rabelink T FIR - Reinders, M E J IR - Reinders ME FIR - Boria Grinyo, J M IR - Boria Grinyo JM FIR - Cusinato, S IR - Cusinato S FIR - Benozzi, L IR - Benozzi L FIR - Savoldi, S IR - Savoldi S FIR - Licata, C IR - Licata C FIR - Mizerska Wasiak, M IR - Mizerska Wasiak M FIR - Martina, G IR - Martina G FIR - Messuerotti, A IR - Messuerotti A FIR - DalCanton, A IR - DalCanton A FIR - Esposito, C IR - Esposito C FIR - Migotto, C IR - Migotto C FIR - Triolo, G IR - Triolo G FIR - Mariano, F IR - Mariano F FIR - Pozzi, C IR - Pozzi C FIR - Boero, R IR - Boero R FIR - Mazzucco, G IR - Mazzucco G FIR - Giannakakis, C IR - Giannakakis C FIR - Honsova, E IR - Honsova E FIR - Sundelin, B IR - Sundelin B FIR - Di Palma, A M IR - Di Palma AM FIR - Ferrario, F IR - Ferrario F FIR - Gutierrez, E IR - Gutierrez E FIR - Asunis, A M IR - Asunis AM FIR - Barratt, J IR - Barratt J FIR - Tardanico, R IR - Tardanico R FIR - Perkowska-Ptasinska, A IR - Perkowska-Ptasinska A FIR - Arce Terroba, J IR - Arce Terroba J FIR - Fortunato, M IR - Fortunato M FIR - Ozluk, Y IR - Ozluk Y FIR - Kilicaslan, I IR - Kilicaslan I FIR - Steenberger, E IR - Steenberger E FIR - Soderberg, M IR - Soderberg M FIR - da Costa Ferreira, A C IR - da Costa Ferreira AC FIR - Riispere, Z IR - Riispere Z FIR - Furci, L IR - Furci L FIR - Orhan, D IR - Orhan D FIR - Kipgen, D IR - Kipgen D FIR - Casartelli, D IR - Casartelli D FIR - Galesic Ljubanovic, D IR - Galesic Ljubanovic D FIR - Bertoni, E IR - Bertoni E FIR - Cannata Ortiz, P IR - Cannata Ortiz P FIR - Groene, H J IR - Groene HJ FIR - Stoppacciaro, A IR - Stoppacciaro A FIR - Bajema, I IR - Bajema I FIR - Bruijn, J IR - Bruijn J FIR - Fulladosa Oliveras, X IR - Fulladosa Oliveras X FIR - Maldyk, J IR - Maldyk J FIR - Ioachim, E IR - Ioachim E EDAT- 2014/04/04 06:00 MHDA- 2015/07/02 06:00 CRDT- 2014/04/04 06:00 PHST- 2013/09/11 00:00 [received] PHST- 2013/12/03 00:00 [revised] PHST- 2014/01/02 00:00 [accepted] PHST- 2014/04/04 06:00 [entrez] PHST- 2014/04/04 06:00 [pubmed] PHST- 2015/07/02 06:00 [medline] AID - S0085-2538(15)30358-6 [pii] AID - 10.1038/ki.2014.63 [doi] PST - ppublish SO - Kidney Int. 2014 Oct;86(4):828-36. doi: 10.1038/ki.2014.63. Epub 2014 Apr 2.