PMID- 38213485 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240113 IS - 2048-8505 (Print) IS - 2048-8513 (Electronic) IS - 2048-8505 (Linking) VI - 17 IP - 1 DP - 2024 Jan TI - Clinicopathological prognostic stratification for proteinuria and kidney survival in IgA nephropathy: a Japanese prospective cohort study. PG - sfad294 LID - 10.1093/ckj/sfad294 [doi] LID - sfad294 AB - BACKGROUND: We require a clinicopathological risk stratification method for immunoglobulin A nephropathy (IgAN) to predict kidney outcomes. We examined a renal failure risk group (RF-RG) classification system created following a prior multicentre, retrospective study to determine if RF-RG could predict kidney outcomes. METHODS: We collected data from Japanese patients with IgAN registered between 1 April 2005 and 31 August 2015. The primary outcome was a composite 50% increase in serum creatinine from baseline or dialysis induction. The secondary outcomes were times to proteinuria remission (ProR) and haematuria remission (HemR). RESULTS: The enrolled 991 patients from 44 facilities were followed for a median of 5.5 years (interquartile range 2.5-7.5), during which 87 composite events (8.8%) occurred. RF-RG was significantly associated with the primary outcome hazard ratio [HR] II 2.78 [95% confidence interval (CI) 1.12-6.93], III 7.15 (2.90-17.6), IV 33.4 (14.1-79.0), I as a reference, P < .001.The discrimination performance was good [C-statistic 0.81 (95% CI 0.76-0.86)] and the time-dependent C-statistics exceeded 0.8 over 10 years. Among the 764 patients with proteinuria and 879 patients with haematuria at baseline, 515 and 645 patients showed ProR and HemR, respectively. ProR was significantly less frequent in patients with advanced disease [subdistribution HR: II 0.79 (95% CI 0.67-0.94), III 0.53 (0.41-0.66), IV 0.15 (0.09-0.23), I as a reference, P < .001]. We also observed an association between HemR and RF-RG. CONCLUSIONS: RF-RG demonstrated good predictive ability for kidney outcomes. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. FAU - Koike, Kentaro AU - Koike K AD - Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. FAU - Kawamura, Tetsuya AU - Kawamura T AD - Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. FAU - Hirano, Keita AU - Hirano K AD - Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. AD - Division of Nephrology, Department of Internal Medicine, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan. FAU - Nishikawa, Masako AU - Nishikawa M AD - Clinical Research Support Center, Jikei University School of Medicine, Tokyo, Japan. FAU - Shimizu, Akira AU - Shimizu A AD - Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan. FAU - Joh, Kensuke AU - Joh K AUID- ORCID: 0000-0002-9334-3664 AD - Department of Pathology, Jikei University School of Medicine, Tokyo, Japan. FAU - Katafuchi, Ritsuko AU - Katafuchi R AD - National Hospital Organization Fukuoka-Higashi Medical Center, Fukuoka, Japan. FAU - Hashiguchi, Akinori AU - Hashiguchi A AD - Department of Pathology, Keio University School of Medicine, Tokyo, Japan. FAU - Yano, Yuichiro AU - Yano Y AUID- ORCID: 0000-0002-2565-7290 AD - Department of Advanced Epidemiology, Noncommunicable Disease Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan. AD - Department of Family Medicine and Community Health, Duke University, Durham, NC, USA. FAU - Matsuzaki, Keiichi AU - Matsuzaki K AD - Kyoto University Health Service, Kyoto, Japan. FAU - Matsushima, Masato AU - Matsushima M AUID- ORCID: 0000-0002-1031-9096 AD - Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan. FAU - Tsuboi, Nobuo AU - Tsuboi N AUID- ORCID: 0000-0002-5407-5265 AD - Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. FAU - Maruyama, Shoichi AU - Maruyama S AUID- ORCID: 0000-0002-8858-632X AD - Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Narita, Ichiei AU - Narita I AD - Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. FAU - Yokoo, Takashi AU - Yokoo T AD - Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. FAU - Suzuki, Yusuke AU - Suzuki Y AD - Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20231127 PL - England TA - Clin Kidney J JT - Clinical kidney journal JID - 101579321 PMC - PMC10783253 OTO - NOTNLM OT - IgA nephropathy OT - clinicopathological grading OT - haematuria OT - kidney prognosis OT - proteinuria COIS- Y.S. has received research funding from Moderna, Travere Therapeutics, Kyowa Kirin, Teijin Pharma, Chinook Therapeutics, Argenx, Aurinia Pharmaceuticals, Pfizer and Rona Bioscience and honoraria from Kyowa Kirin, Novartis, Mitsubishi Tanabe Pharma, Otsuka Pharmaceutical, Daiichi Sankyo and AstraZeneca. K.K. worked at IQVIA Services Japan, a contract research and sales organization, and works at Syneos Health Clinical Solutions, a contract research and sales organization. EDAT- 2024/01/12 06:42 MHDA- 2024/01/12 06:43 PMCR- 2023/11/27 CRDT- 2024/01/12 03:40 PHST- 2023/06/18 00:00 [received] PHST- 2024/01/12 06:43 [medline] PHST- 2024/01/12 06:42 [pubmed] PHST- 2024/01/12 03:40 [entrez] PHST- 2023/11/27 00:00 [pmc-release] AID - sfad294 [pii] AID - 10.1093/ckj/sfad294 [doi] PST - epublish SO - Clin Kidney J. 2023 Nov 27;17(1):sfad294. doi: 10.1093/ckj/sfad294. eCollection 2024 Jan.