The Feasibility of Japanese Histological Grade Classification for Predicting Renal Function Deterioration among Taiwanese Individuals with IgA Nephropathy

We aimed to validate the Japanese histological grading classification (JHGC) in our population of IgA immunoglobulin (IgAN) cases. We conducted a retrospective cohort study at Taichung Veterans General Hospital in Taiwan from January 2011 to December 2023. The process involved assessing JHGC's...

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Bibliographic Details
Published in:	Journal of clinical medicine 2023-11, Vol.12 (23), p.7339
Main Authors:	Chen, Cheng-Hsu, Wu, Ming-Ju, Tsai, Shang-Feng
Format:	Article
Language:	eng
Subjects:	Analysis Biopsy Blood Care and treatment Classification Clinical medicine composite renal outcome Creatinine Diagnosis Disease end-stage kidney disease (ESKD) glomerular filtration rate (GFR) Hemoglobin Histology IgA glomerulonephritis IgA nephropathy (IgAN) Immunoglobulin A Japanese Histological Grade Classification (JHGC) Kidney diseases Kidney function tests Medical records Oxford classification
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Summary:	We aimed to validate the Japanese histological grading classification (JHGC) in our population of IgA immunoglobulin (IgAN) cases. We conducted a retrospective cohort study at Taichung Veterans General Hospital in Taiwan from January 2011 to December 2023. The process involved assessing JHGC's clinical, histological, and merged grading system. Composite renal outcomes based on glomerular filtrate rate (eGFR) were considered. The study included 359 IgAN by renal biopsies. Kidney function at the time of biopsy was suboptimal, with average SCr of 1.3 mg/dL, eGFR of 54.0 mL/min/1.732 m , and urine protein-creatinine ratio (UPCR) of 1.2 mg/mg. JHGC effectively identified different severity levels of histological and clinical aspects in Taiwanese IgAN. Initial 4-histological classification showed significantly higher MEST-C scores ( < 0.001). Merging grade III and IV was reasonable in Japanese and Taiwanese populations. The clinical grading system (3C) was associated with histological status and proteinuria, but there was no significant trend with SCr, eGFR, and blood urea nitrogen. Significant differences were found among the three groups (log-rank < 0.01), but C-grade I and II lacked significant difference in long-term renal outcomes. We separated UPCR < 0.5 mg/mg into two groups: eGFR≥ and
ISSN:	2077-0383 2077-0383