BACKGROUND: Although the Oxford classification of IgA nephropathy appears valid, we found crescents were significantly related to renal outcome in our cohort, whereas segmental glomerulosclerosis (S) was not. The timing of renal biopsy may significantly affect the variables in the Oxford classification. METHOD: The relationship between biopsy timing and pathological variables (mesangial hypercellularity score [M], endocapillary hypercellularity [E], S, tubular atrophy/interstitial fibrosis [T], crescents, and global glomerulosclerosis [G]) was analyzed retrospectively in 250 children with IgA nephropathy. RESULTS: The median time from disease onset to renal biopsy was 5.1 months (interquartile range, 2.7-15.4). M (ρ = -0.26, P < 0.0001), E (ρ = -0.34, P < 0.0001), and crescents (ρ = -0.14, P = 0.023) showed significant negative correlations, and S (ρ = 0.15, P = 0.018) and G (ρ = 0.25, P < 0.0001) showed significant positive correlations with time to biopsy (Spearman test). M, E, and crescents differed significantly in renal biopsies obtained before and after 3 years from onset (Wilcoxon test). Most crescents (92.9 %) were cellular/fibrocellular and were acute lesions. As crescents formed early after disease onset and decreased over time, they may be prognostic for acute phase, but not for chronic phase disease. CONCLUSIONS: Renal biopsy timing may alter the significance of variables used in the Oxford classification.
BACKGROUND: Although the Oxford classification of IgA nephropathy appears valid, we found crescents were significantly related to renal outcome in our cohort, whereas segmental glomerulosclerosis (S) was not. The timing of renal biopsy may significantly affect the variables in the Oxford classification. METHOD: The relationship between biopsy timing and pathological variables (mesangial hypercellularity score [M], endocapillary hypercellularity [E], S, tubular atrophy/interstitial fibrosis [T], crescents, and global glomerulosclerosis [G]) was analyzed retrospectively in 250 children with IgA nephropathy. RESULTS: The median time from disease onset to renal biopsy was 5.1 months (interquartile range, 2.7-15.4). M (ρ = -0.26, P < 0.0001), E (ρ = -0.34, P < 0.0001), and crescents (ρ = -0.14, P = 0.023) showed significant negative correlations, and S (ρ = 0.15, P = 0.018) and G (ρ = 0.25, P < 0.0001) showed significant positive correlations with time to biopsy (Spearman test). M, E, and crescents differed significantly in renal biopsies obtained before and after 3 years from onset (Wilcoxon test). Most crescents (92.9 %) were cellular/fibrocellular and were acute lesions. As crescents formed early after disease onset and decreased over time, they may be prognostic for acute phase, but not for chronic phase disease. CONCLUSIONS: Renal biopsy timing may alter the significance of variables used in the Oxford classification.
Authors: Ian S D Roberts; H Terence Cook; Stéphan Troyanov; Charles E Alpers; Alessandro Amore; Jonathan Barratt; Francois Berthoux; Stephen Bonsib; Jan A Bruijn; Daniel C Cattran; Rosanna Coppo; Vivette D'Agati; Giuseppe D'Amico; Steven Emancipator; Francesco Emma; John Feehally; Franco Ferrario; Fernando C Fervenza; Sandrine Florquin; Agnes Fogo; Colin C Geddes; Hermann-Josef Groene; Mark Haas; Andrew M Herzenberg; Prue A Hill; Ronald J Hogg; Stephen I Hsu; J Charles Jennette; Kensuke Joh; Bruce A Julian; Tetsuya Kawamura; Fernand M Lai; Lei-Shi Li; Philip K T Li; Zhi-Hong Liu; Bruce Mackinnon; Sergio Mezzano; F Paolo Schena; Yasuhiko Tomino; Patrick D Walker; Haiyan Wang; Jan J Weening; Nori Yoshikawa; Hong Zhang Journal: Kidney Int Date: 2009-07-01 Impact factor: 10.612
Authors: Daniel C Cattran; Rosanna Coppo; H Terence Cook; John Feehally; Ian S D Roberts; Stéphan Troyanov; Charles E Alpers; Alessandro Amore; Jonathan Barratt; Francois Berthoux; Stephen Bonsib; Jan A Bruijn; Vivette D'Agati; Giuseppe D'Amico; Steven Emancipator; Francesco Emma; Franco Ferrario; Fernando C Fervenza; Sandrine Florquin; Agnes Fogo; Colin C Geddes; Hermann-Josef Groene; Mark Haas; Andrew M Herzenberg; Prue A Hill; Ronald J Hogg; Stephen I Hsu; J Charles Jennette; Kensuke Joh; Bruce A Julian; Tetsuya Kawamura; Fernand M Lai; Chi Bon Leung; Lei-Shi Li; Philip K T Li; Zhi-Hong Liu; Bruce Mackinnon; Sergio Mezzano; F Paolo Schena; Yasuhiko Tomino; Patrick D Walker; Haiyan Wang; Jan J Weening; Nori Yoshikawa; Hong Zhang Journal: Kidney Int Date: 2009-07-01 Impact factor: 10.612
Authors: Imke Hennies; Charlotte Gimpel; Jutta Gellermann; Kristina Möller; Brigitte Mayer; Katalin Dittrich; Anja K Büscher; Matthias Hansen; Wiebke Aulbert; Elke Wühl; Richard Nissel; Gessa Schalk; Lutz T Weber; Michael Pohl; Simone Wygoda; Rolf Beetz; Günter Klaus; Henry Fehrenbach; Sabine König; Hagen Staude; Ortraud Beringer; Martin Bald; Ulrike Walden; Christian von Schnakenburg; Gunhard Bertram; Michael Wallot; Karsten Häffner; Thorsten Wiech; Peter F Hoyer; Martin Pohl Journal: Pediatr Nephrol Date: 2017-10-05 Impact factor: 3.714