Details

Autor(en) / Beteiligte

• Barbour, Sean J.
• Espino-Hernandez, Gabriela
• Herzenberg, Andrew M.
• Cook, T.
• Troyanov, S.
• Alpers, C.
• Berthoux, F.
• Bonsib, S.
• D’Agati, V.
• Emancipator, S.
• Florquin, S.
• Groene, H.
• Hill, P.
• Hogg, R.
• Hsu, S.
• Hunley, T.
• Jennette, C.
• Joh, K.
• Julian, B.
• Leung, C.
• Liu, Z.
• Massat, A.
• Mackinnon, B.
• Walker, P.
• Weening, J.
• Yoshikawa, N.
• Zhang, H.
• Cattran, D.C.
• Feehally, J.
• Maixnerova, D.
• Lundberg, S.
• Fuiano, L.
• Beltrame, G.
• Rollino, C.
• Camilla, R.
• Peruzzi, L.
• Praga, M.
• Polci, R.
• Segoloni, G.
• Colla, L.
• Pani, A.
• Angioi, A.
• Piras, L.
• JF
• Cancarini, G.
• Ravera, S.
• Durlik, M.
• Moggia, E.
• Pugliese, F.
• Caliskan, Y.
• Sever, M.
• Locatelli, F.
• Del Vecchio, L.
• Wetzels, J.F.M.
• Berg, U.
• Ots-Rosenberg, M.
• Topaloglu, R.
• D’Amico, M.
• Stangou, M.
• Giacchino, F.
• Goumenos, D.
• Siamopoulos, K.
• Galliani, M.
• Quaglia, M.
• Salvadori, M.
• Cirami, L.
• Kloster Smerud, H.
• Stellato, T.
• Egido, J.
• Martin, C.
• Floege, J.
• Eitner, F.
• Bernich, P.
• Menè, P.
• Morosetti, M.
• van Kooten, C.
• Rabelink, T.
• Reinders, M.E.J.
• Boria Grinyo, J.M.
• Cusinato, S.
• Savoldi, S.
• Mizerska-Wasiak, M.
• Martina, G.
• Migotto, C.
• Triolo, G.
• Mariano, F.
• Boero, R.
• Giannakakis, C.
• Honsova, E.
• Sundelin, B.
• Di Palma, A.M.
• Asunis, A.M.
• Tardanico, R.
• Perkowska-Ptasinska, A.
• Pantzaki, A.
• Riispere, Z.
• Casartelli, D.
• Cannata Ortiz, P.
• Bajema, I.
• Ioachim, E.

Titel

The MEST score provides earlier risk prediction in lgA nephropathy

Ist Teil von

• Kidney international, 2016-01, Vol.89 (1), p.167-175

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• The Oxford Classification of IgA nephropathy (IgAN) includes the following four histologic components: mesangial (M) and endocapillary (E) hypercellularity, segmental sclerosis (S) and interstitial fibrosis/tubular atrophy (T). These combine to form the MEST score and are independently associated with renal outcome. Current prediction and risk stratification in IgAN requires clinical data over 2 years of follow-up. Using modern prediction tools, we examined whether combining MEST with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than current best methods that use 2 years of follow-up data. We used a cohort of 901 adults with IgAN from the Oxford derivation and North American validation studies and the VALIGA study followed for a median of 5.6 years to analyze the primary outcome (50% decrease in eGFR or ESRD) using Cox regression models. Covariates of clinical data at biopsy (eGFR, proteinuria, MAP) with or without MEST, and then 2-year clinical data alone (2-year average of proteinuria/MAP, eGFR at biopsy) were considered. There was significant improvement in prediction by adding MEST to clinical data at biopsy. The combination predicted the outcome as well as the 2-year clinical data alone, with comparable calibration curves. This effect did not change in subgroups treated or not with RAS blockade or immunosuppression. Thus, combining the MEST score with cross-sectional clinical data at biopsy provides earlier risk prediction in IgAN than our current best methods.