title: A multicenter application and evaluation of the oxford classification of IgA nephropathy in adult chinese patients.
abstract: BACKGROUND
  The Oxford classification of immunoglobulin A (IgA) nephropathy (IgAN) provides a histopathologic grading system that is associated with kidney disease outcomes independent of clinical features. We evaluated the Oxford IgAN classification in a large cohort of patients from China.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  1,026 adults with IgAN from 18 referral centers in China. Inclusion criteria and statistical analysis were similar to the Oxford study.
  
  
  METHODS
  Histologic findings of mesangial hypercellularity score, endocapillary proliferation, segmental sclerosis or adhesion, crescents, necrosis, and tubular atrophy/interstitial fibrosis. Clinical features, blood pressure, estimated glomerular filtration rate (eGFR), proteinuria, and treatment modalities.
  
  
  RESULTS
  Time to a 50% reduction in eGFR or end-stage renal disease (the combined event); the rate of eGFR decline (slope of eGFR); proteinuria during follow-up.
  
  
  RESULTS
  Compared with the Oxford cohort, the Chinese cohort had a lower proportion of patients with mesangial hypercellularity (43%) and endocapillary proliferation (11%), higher proportion with segmental sclerosis or adhesion (83%) and necrosis (15%), and similar proportion with crescents (48%) and tubular atrophy/interstitial fibrosis (moderate, 24%; severe, 3.3%). During a median follow-up of 53 (25th-75th percentile, 36-67) months, 159 (15.5%) patients reached the combined event. Our study showed that patients with a mesangial hypercellularity score higher than 0.5 were associated with a 2.0-fold (95% CI, 1.5-2.8; P<0.001) higher risk of the combined event than patients with a score of 0.5 or lower. Patients with tubular atrophy/interstitial fibrosis of 25%-50% and >50% versus <25% were associated with a 3.7-fold (95% CI, 2.6-5.1; P<0.001) and 15.1-fold (95% CI, 9.5-24.2; P<0.001) higher risk of the combined event, respectively. Endocapillary proliferation, glomerular crescents, and necrosis were not significant.
  
  
  CONCLUSIONS
  Retrospective study; the therapeutic interventions were miscellaneous.
  
  
  CONCLUSIONS
  We confirmed the associations of mesangial hypercellularity and tubular atrophy/interstitial fibrosis with kidney disease outcomes.
authors: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Cai-Hong
authors: CH
authors: Zeng
authors: Weibo
authors: W
authors: Le
authors: Zhaohui
authors: Z
authors: Ni
authors: Minfang
authors: M
authors: Zhang
authors: Lining
authors: L
authors: Miao
authors: Ping
authors: P
authors: Luo
authors: Rong
authors: R
authors: Wang
authors: Zhimei
authors: Z
authors: Lv
authors: Jianghua
authors: J
authors: Chen
authors: Jiong
authors: J
authors: Tian
authors: Nan
authors: N
authors: Chen
authors: Xiaoxia
authors: X
authors: Pan
authors: Ping
authors: P
authors: Fu
authors: Zhangxue
authors: Z
authors: Hu
authors: Lining
authors: L
authors: Wang
authors: Qiuling
authors: Q
authors: Fan
authors: Hongguang
authors: H
authors: Zheng
authors: Dewei
authors: D
authors: Zhang
authors: Yaping
authors: Y
authors: Wang
authors: Yanhong
authors: Y
authors: Huo
authors: Hongli
authors: H
authors: Lin
authors: Shuni
authors: S
authors: Chen
authors: Shiren
authors: S
authors: Sun
authors: Yanxia
authors: Y
authors: Wang
authors: Zhangsuo
authors: Z
authors: Liu
authors: Dong
authors: D
authors: Liu
authors: Lu
authors: L
authors: Ma
authors: Tao
authors: T
authors: Pan
authors: Aiping
authors: A
authors: Zhang
authors: Xiaoyu
authors: X
authors: Jiang
authors: Changying
authors: C
authors: Xing
authors: Bing
authors: B
authors: Sun
authors: Qiaoling
authors: Q
authors: Zhou
authors: Wenbing
authors: W
authors: Tang
authors: Fuyou
authors: F
authors: Liu
authors: Yinghong
authors: Y
authors: Liu
authors: Shaoshan
authors: S
authors: Liang
authors: Feng
authors: F
authors: Xu
authors: Qian
authors: Q
authors: Huang
authors: Hongbing
authors: H
authors: Shen
authors: Jianming
authors: J
authors: Wang
authors: Yu
authors: Y
authors: Shyr
authors: Sharon
authors: S
authors: Phillips
authors: Stéphan
authors: S
authors: Troyanov
authors: Stéphan
authors: S
authors: Trojanov
authors: Agnes
authors: A
authors: Fogo
authors: Zhi-Hong
authors: ZH
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D005260:Female; D005922:Glomerulonephritis, IGA / Q000145:classification* / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult