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@article{Coppo:2020:ndt/gfy302,
author = {Coppo, R and D'Arrigo, G and Tripepi, G and Russo, ML and Roberts, ISD and Bellur, S and Cattran, D and Cook, TH and Feehally, J and Tesar, V and Maixnerova, D and Peruzzi, L and Amore, A and Lundberg, S and Di, Palma AM and Gesualdo, L and Emma, F and Rollino, C and Praga, M and Biancone, L and Pani, A and Feriozzi, S and Polci, R and Barratt, J and Del, Vecchio L and Locatelli, F and Pierucci, A and Caliskan, Y and Perkowska-Ptasinska, A and Durlik, M and Moggia, E and Ballarin, JC and Wetzels, JFM and Goumenos, D and Papasotiriou, M and Galesic, K and Toric, L and Papagianni, A and Stangou, M and Benozzi, L and Cusinato, S and Berg, U and Topaloglu, R and Maggio, M and Ots-Rosenberg, M and D'Amico, M and Geddes, C and Balafa, O and Quaglia, M and Cravero, R and Lino, Cirami C and Fellstrom, B and Floege, J and Egido, J and Mallamaci, F and Zoccali, C and ERA-EDTA, Immunonephrology Working Group},
doi = {ndt/gfy302},
journal = {Nephrol Dial Transplant},
pages = {1002--1009},
title = {Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update.},
url = {http://dx.doi.org/10.1093/ndt/gfy302},
volume = {35},
year = {2020}
}

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TY  - JOUR
AB  - BACKGROUND: It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up. METHODS: In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1-10.8)]. RESULTS: In this extended analysis, M1, S1 and T1-T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P < 0.01), and there was no effect modification by age for these associations, suggesting that they may be valid in children and in adults as well. Only T lesions were associated with the rate of eGFR loss in the whole cohort, whereas C showed this association only in patients not treated with immunosuppression. In separate prognostic analyses, the whole set of pathology lesions provided a gain in discrimination power over the clinical variables alone, which was similar at 5 years (+2.0%) and for the whole follow-up (+1.8%). A similar benefit was observed for risk reclassification analyses (+2.7% and +2.4%). CONCLUSION: Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.
AU  - Coppo,R
AU  - D'Arrigo,G
AU  - Tripepi,G
AU  - Russo,ML
AU  - Roberts,ISD
AU  - Bellur,S
AU  - Cattran,D
AU  - Cook,TH
AU  - Feehally,J
AU  - Tesar,V
AU  - Maixnerova,D
AU  - Peruzzi,L
AU  - Amore,A
AU  - Lundberg,S
AU  - Di,Palma AM
AU  - Gesualdo,L
AU  - Emma,F
AU  - Rollino,C
AU  - Praga,M
AU  - Biancone,L
AU  - Pani,A
AU  - Feriozzi,S
AU  - Polci,R
AU  - Barratt,J
AU  - Del,Vecchio L
AU  - Locatelli,F
AU  - Pierucci,A
AU  - Caliskan,Y
AU  - Perkowska-Ptasinska,A
AU  - Durlik,M
AU  - Moggia,E
AU  - Ballarin,JC
AU  - Wetzels,JFM
AU  - Goumenos,D
AU  - Papasotiriou,M
AU  - Galesic,K
AU  - Toric,L
AU  - Papagianni,A
AU  - Stangou,M
AU  - Benozzi,L
AU  - Cusinato,S
AU  - Berg,U
AU  - Topaloglu,R
AU  - Maggio,M
AU  - Ots-Rosenberg,M
AU  - D'Amico,M
AU  - Geddes,C
AU  - Balafa,O
AU  - Quaglia,M
AU  - Cravero,R
AU  - Lino,Cirami C
AU  - Fellstrom,B
AU  - Floege,J
AU  - Egido,J
AU  - Mallamaci,F
AU  - Zoccali,C
AU  - ERA-EDTA,Immunonephrology Working Group
DO  - ndt/gfy302
EP  - 1009
PY  - 2020///
SP  - 1002
TI  - Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update.
T2  - Nephrol Dial Transplant
UR  - http://dx.doi.org/10.1093/ndt/gfy302
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30418652
VL  - 35
ER  -

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