Outcomes of immunosuppression in IGA nephropathy based on the oxford classification
Joint Authors
Palamuthusingam, Dharmenaan
Castledine, Clare
Lawman, Sarah
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 29, Issue 2 (30 Apr. 2018), pp.341-350, 10 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2018-04-30
Country of Publication
Saudi Arabia
No. of Pages
10
Main Subjects
Abstract EN
Numerous studies have addressed the predictive value of pathology findings from the Oxford Classification.
Whether this influences treatment choice has not been determined.
We evaluated patients with IgA nephropathy who were immunosuppressed and correlated our findings with both clinical and histological features as per the Oxford Classification.
This was a retrospective observational study of 45 patients who had biopsy-proven IgA nephropathy with a mean follow-up of 2.6 years.
Primary outcomes were time to end-stage renal disease (ESRD) or a 50% rise in serum creatinine.
Immunosuppression was not associated with lower hazards for both ESRD and 50% rise in serum creatinine.
From the Oxford Classification, only T0 was associated with significantly lower hazards for ESRD [hazard ratio (HR), 0.067; confidence interval (CI) 0.01–0.58].
Patients who had crescents and/or necrotizing lesions on biopsy were more likely to be immunosuppressed (odds ratio 9.99; 95% CI 1.99–50.06, P = 0.005) but demonstrated a statistically nonsignificant higher hazard for both renal end points (HR, 1.61; CI 0.19–13.89).
Such lesions were also associated with a higher incidence of hypertension (149 vs.
135 mm Hg) and greater proteinuria (2.7 vs.
1.9 g/day) at presentation.
The use of the Oxford Classification did not aid decision-making with regard to the use of immunosuppression.
Crescents and/or necrosis identified on histology were associated with the use of immunosuppression.
Hence, there is a need for these lesions to be evaluated further in large cohorts and incorporated into future disease classifications.
American Psychological Association (APA)
Palamuthusingam, Dharmenaan& Castledine, Clare& Lawman, Sarah. 2018. Outcomes of immunosuppression in IGA nephropathy based on the oxford classification. Saudi Journal of Kidney Diseases and Transplantation،Vol. 29, no. 2, pp.341-350.
https://search.emarefa.net/detail/BIM-838522
Modern Language Association (MLA)
Palamuthusingam, Dharmenaan…[et al.]. Outcomes of immunosuppression in IGA nephropathy based on the oxford classification. Saudi Journal of Kidney Diseases and Transplantation Vol. 29, no. 2 (Mar. / Apr. 2018), pp.341-350.
https://search.emarefa.net/detail/BIM-838522
American Medical Association (AMA)
Palamuthusingam, Dharmenaan& Castledine, Clare& Lawman, Sarah. Outcomes of immunosuppression in IGA nephropathy based on the oxford classification. Saudi Journal of Kidney Diseases and Transplantation. 2018. Vol. 29, no. 2, pp.341-350.
https://search.emarefa.net/detail/BIM-838522
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 350
Record ID
BIM-838522