Validation of the Japanese histologic classification 2013 of immunoglobulin A XXXX for prediction of long-term prognosis in a Japanese single-center cohort.

@entity1 @entity8 @entity1463 @entity70824 @entity17484 @entity17485 @entity454
BACKGROUND: A new Japanese histologic classification (JHC) of immunoglobulin A @entity8 (IgAN) for prediction of long-term prognosis was proposed in 2013. The goal of this study was to validate the JHC system in a Japanese single-center cohort. METHODS: A retrospective study was conducted in 198 Japanese adult @entity1 with IgAN. Clinical findings including blood pressure, urinary protein, estimated glomerular filtration rate (eGFR), and outcomes were evaluated in these @entity1 . The @entity8 percentage score (GLPS) [number of glomeruli with cellular crescents, fibrocellular crescents, @entity1463 , segmental @entity1463 , or fibrous crescents/number of total obtained glomeruli     100 (%)] was assessed in each @entity1 and categorized into histologic grades (HGs) of @entity17485 (<25  %), @entity17484 (25-49  %), and @entity70824 (>= 50  %). Associations of GLPS (HG) with disease progression (50  % eGFR decline or @entity454 requiring dialysis) within 10  years after biopsy and the rate of annual eGFR decline were examined. RESULTS: During a median follow-up period of 12.0  years after biopsy, disease progression occurred in 12.8  % (12/94) of @entity17485 @entity1 , 32.3  % (21/65) of @entity17484 @entity1 , and 46.2  % (18/39) of @entity70824 @entity1 . The risk of disease progression was significantly higher in the @entity17484 and @entity70824 groups than in the @entity17485 group (odds ratios: 3.3 and 5.9 vs. 1). A higher GLPS was significantly associated with a higher risk of disease progression and a greater annual eGFR decline. CONCLUSION: The newly proposed JHC system 2013 based on GLPS (HG) was well correlated with long-term prognosis in our cohort of Japanese adult @entity1 with IgAN.
