title: The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification.
abstract: IgA nephropathy is the most common glomerular disease worldwide, yet there is no international consensus for its pathological or clinical classification. Here a new classification for IgA nephropathy is presented by an international consensus working group. The goal of this new system was to identify specific pathological features that more accurately predict risk of progression of renal disease in IgA nephropathy, thus enabling both clinicians and pathologists to improve individual patient prognostication. In a retrospective analysis, sequential clinical data were obtained on 265 adults and children with IgA nephropathy who were followed for a median of 5 years. Renal biopsies from all patients were scored by pathologists blinded to the clinical data for pathological variables identified as reproducible by an iterative process. Four of these variables: (1) the mesangial hypercellularity score, (2) segmental glomerulosclerosis, (3) endocapillary hypercellularity, and (4) tubular atrophy/interstitial fibrosis were subsequently shown to have independent value in predicting renal outcome. These specific pathological features withstood rigorous statistical analysis even after taking into account all clinical indicators available at the time of biopsy as well as during follow-up. The features have prognostic significance and we recommended they be taken into account for predicting outcome independent of the clinical features both at the time of presentation and during follow-up. The value of crescents was not addressed due to their low prevalence in the enrolled cohort.
authors: University Health Network, Toronto General Research Institute, Toronto, Ontario, Canada.
authors: Daniel C
authors: DC
authors: Cattran
authors: Rosanna
authors: R
authors: Coppo
authors: H Terence
authors: HT
authors: Cook
authors: John
authors: J
authors: Feehally
authors: Ian S D
authors: IS
authors: Roberts
authors: Stéphan
authors: S
authors: Troyanov
authors: Charles E
authors: CE
authors: Alpers
authors: Alessandro
authors: A
authors: Amore
authors: Jonathan
authors: J
authors: Barratt
authors: Francois
authors: F
authors: Berthoux
authors: Stephen
authors: S
authors: Bonsib
authors: Jan A
authors: JA
authors: Bruijn
authors: Vivette
authors: V
authors: D'Agati
authors: Giuseppe
authors: G
authors: D'Amico
authors: Steven
authors: S
authors: Emancipator
authors: Francesco
authors: F
authors: Emma
authors: Franco
authors: F
authors: Ferrario
authors: Fernando C
authors: FC
authors: Fervenza
authors: Sandrine
authors: S
authors: Florquin
authors: Agnes
authors: A
authors: Fogo
authors: Colin C
authors: CC
authors: Geddes
authors: Hermann-Josef
authors: HJ
authors: Groene
authors: Mark
authors: M
authors: Haas
authors: Andrew M
authors: AM
authors: Herzenberg
authors: Prue A
authors: PA
authors: Hill
authors: Ronald J
authors: RJ
authors: Hogg
authors: Stephen I
authors: SI
authors: Hsu
authors: J Charles
authors: JC
authors: Jennette
authors: Kensuke
authors: K
authors: Joh
authors: Bruce A
authors: BA
authors: Julian
authors: Tetsuya
authors: T
authors: Kawamura
authors: Fernand M
authors: FM
authors: Lai
authors: Chi Bon
authors: CB
authors: Leung
authors: Lei-Shi
authors: LS
authors: Li
authors: Philip K T
authors: PK
authors: Li
authors: Zhi-Hong
authors: ZH
authors: Liu
authors: Bruce
authors: B
authors: Mackinnon
authors: Sergio
authors: S
authors: Mezzano
authors: F Paolo
authors: FP
authors: Schena
authors: Yasuhiko
authors: Y
authors: Tomino
authors: Patrick D
authors: PD
authors: Walker
authors: Haiyan
authors: H
authors: Wang
authors: Jan J
authors: JJ
authors: Weening
authors: Nori
authors: N
authors: Yoshikawa
authors: Hong
authors: H
authors: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000145:classification* / Q000208:ethnology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D008875:Middle Aged