Comparison of the Haas and the Oxford classifications for prediction of renal outcome in patients with IgA nephropathy

Kyoung Sook Park, SeungHyeok Han, Jeong Hae Kie, Ki Heon Nam, Mi Jung Lee, Beom Jin Lim, Young Eun Kwon, Yung Ly Kim, Seong Yeong An, Chan Ho Kim, Fa Mee Doh, Hyang Mo Koo, Hyung Jung Oh, Shin-Wook Kang, Kyu Hun Choi, Hyeon Joo Jeong, TaeHyun Yoo

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Abstract

Pathologic features can provide valuable information for determining prognosis in IgA nephropathy (IgAN). However, it is uncertain whether the Oxford classification, a new classification of IgAN, can predict renal outcome better than previous ones. We conducted a retrospective cohort study in 500 patients with biopsy-proven IgAN between January 2002 and December 2010 to compare the ability of the Haas and the Oxford classifications to predict renal outcome. Primary outcome was a doubling of the baseline serum creatinine concentration (D-SCr). During a mean follow-up of 68 months, 52 (10.4%) and 35 (7.0%) developed D-SCr and end-stage renal disease, respectively. There were graded increases in the development of D-SCr in the higher Haas classes. In addition, the primary endpoint of D-SCr occurred more in patients with the Oxford M and T lesions than those without such lesions. In multivariate Cox regression analyses, the Haas class V (HR, 12.19; P =.002) and the Oxford T1 (hazard ratio [HR], 6.68; P <.001) and T2 (HR, 12.16; P <.001) lesions were independently associated with an increased risk of reaching D-SCr. Harrell's C index of each multivariate model with the Haas and the Oxford classification was 0.867 (P =.015) and 0.881 (P =.004), respectively. This was significantly higher than that of model with clinical factors only (C = 0.819). However, there was no difference in C-statistics between the 2 models with the Haas and the Oxford classifications (P =.348). This study suggests that the Haas and the Oxford classifications are comparable in predicting progression of IgAN.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalHuman Pathology
Volume45
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

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All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Park, K. S., Han, S., Kie, J. H., Nam, K. H., Lee, M. J., Lim, B. J., Kwon, Y. E., Kim, Y. L., An, S. Y., Kim, C. H., Doh, F. M., Koo, H. M., Oh, H. J., Kang, S-W., Choi, K. H., Jeong, H. J., & Yoo, T. (2014). Comparison of the Haas and the Oxford classifications for prediction of renal outcome in patients with IgA nephropathy. Human Pathology, 45(2), 236-243. https://doi.org/10.1016/j.humpath.2013.08.019