Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis
Abstract Background Henoch-Schönlein purpura nephritis (HSPN) shares many similarities with IgA nephropathy. We aimed to analyze the predictive value of the International Study of Kidney Disease in Children (ISKDC) classification and the updated Oxford classification for IgA nephropathy in HSPN pati...
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doaj-fe7cfd5077244da588ff83b90a6de1b72020-11-25T03:36:45ZengBMCDiagnostic Pathology1746-15962019-05-011411810.1186/s13000-019-0818-0Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritisXiaohan Huang0Lili Ma1Pingping Ren2Hongya Wang3Liangliang Chen4Haidongqin Han5Jianghua Chen6Fei Han7Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityKidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityAbstract Background Henoch-Schönlein purpura nephritis (HSPN) shares many similarities with IgA nephropathy. We aimed to analyze the predictive value of the International Study of Kidney Disease in Children (ISKDC) classification and the updated Oxford classification for IgA nephropathy in HSPN patients. Methods Data of 275 HSPN patients (aged≥14 years) were retrieved, and all of them underwent a renal biopsy. We re-classified the biopsies according to the ISKDC classification and the updated Oxford classification to analyze their correlations with clinical features and renal outcomes. The renal endpoints were defined as ≥30% reduction in baseline estimated glomerular filtration rate (eGFR) in 2 years, doubling of serum creatinine (Scr) or end stage renal disease. Results During follow-up period of 56(30,86) months, 30(10.9%) patients reached renal endpoints. Segmental sclerosis was the only pathological feature independently associated with renal endpoints (HR 4.086, 95%CI 1.111–15.026, P = 0.034). Tubular atrophy/ interstitial fibrosis was associated with eGFR and Scr levels, and its correlation with renal endpoints was found by univariate analysis. Endocapillary hypercellularity was associated with 24 h urine protein and is of prognostic value in univariate analysis. Mesangial hypercellularity was not associated with clinical features or renal endpoints. Crescents were associated with 24 h urine protein, Scr and eGFR levels, but both ISKDC and updated Oxford classifications of crescents were not associated with renal endpoints by multivariate analysis. Conclusions The updated Oxford classification can help in disease management and renal outcome prediction of HSPN.http://link.springer.com/article/10.1186/s13000-019-0818-0IgA vasculitisNephritisRenal biopsyCrescentOutcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xiaohan Huang Lili Ma Pingping Ren Hongya Wang Liangliang Chen Haidongqin Han Jianghua Chen Fei Han |
spellingShingle |
Xiaohan Huang Lili Ma Pingping Ren Hongya Wang Liangliang Chen Haidongqin Han Jianghua Chen Fei Han Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis Diagnostic Pathology IgA vasculitis Nephritis Renal biopsy Crescent Outcomes |
author_facet |
Xiaohan Huang Lili Ma Pingping Ren Hongya Wang Liangliang Chen Haidongqin Han Jianghua Chen Fei Han |
author_sort |
Xiaohan Huang |
title |
Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis |
title_short |
Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis |
title_full |
Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis |
title_fullStr |
Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis |
title_full_unstemmed |
Updated Oxford classification and the international study of kidney disease in children classification: application in predicting outcome of Henoch-Schönlein purpura nephritis |
title_sort |
updated oxford classification and the international study of kidney disease in children classification: application in predicting outcome of henoch-schönlein purpura nephritis |
publisher |
BMC |
series |
Diagnostic Pathology |
issn |
1746-1596 |
publishDate |
2019-05-01 |
description |
Abstract Background Henoch-Schönlein purpura nephritis (HSPN) shares many similarities with IgA nephropathy. We aimed to analyze the predictive value of the International Study of Kidney Disease in Children (ISKDC) classification and the updated Oxford classification for IgA nephropathy in HSPN patients. Methods Data of 275 HSPN patients (aged≥14 years) were retrieved, and all of them underwent a renal biopsy. We re-classified the biopsies according to the ISKDC classification and the updated Oxford classification to analyze their correlations with clinical features and renal outcomes. The renal endpoints were defined as ≥30% reduction in baseline estimated glomerular filtration rate (eGFR) in 2 years, doubling of serum creatinine (Scr) or end stage renal disease. Results During follow-up period of 56(30,86) months, 30(10.9%) patients reached renal endpoints. Segmental sclerosis was the only pathological feature independently associated with renal endpoints (HR 4.086, 95%CI 1.111–15.026, P = 0.034). Tubular atrophy/ interstitial fibrosis was associated with eGFR and Scr levels, and its correlation with renal endpoints was found by univariate analysis. Endocapillary hypercellularity was associated with 24 h urine protein and is of prognostic value in univariate analysis. Mesangial hypercellularity was not associated with clinical features or renal endpoints. Crescents were associated with 24 h urine protein, Scr and eGFR levels, but both ISKDC and updated Oxford classifications of crescents were not associated with renal endpoints by multivariate analysis. Conclusions The updated Oxford classification can help in disease management and renal outcome prediction of HSPN. |
topic |
IgA vasculitis Nephritis Renal biopsy Crescent Outcomes |
url |
http://link.springer.com/article/10.1186/s13000-019-0818-0 |
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