Journal of Nepal Medical Association (Jul 2024)

MEST C Score and Treatment Response in IgA Nephropathy in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

  • Sushma Thapa,
  • Mahesh Raj Sigdel

DOI
https://doi.org/10.31729/jnma.8707
Journal volume & issue
Vol. 62, no. 276

Abstract

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Introduction: IgA nephropathy is the leading cause of primary glomerulonephritis worldwide. The Oxford classification can predict IgA nephropathy prognosis through renal biopsy however its applicability to the Nepalese population remains unexplored. This study aimed to evaluate the MEST-C score and treatment response in patients with IgA nephropathy. Methods: This descriptive cross-sectional study was conducted at a tertiary care center from November 2021 to November 2022. Ethical approval was obtained from the Institutional Review Committee of the same institute [IRC-193(6-11)t2078/079]. Total population sampling was done. Fifty-two consenting patients aged 16 or older with confirmed IgA nephropathy were included, excluding those with liver disease or expected survival of less than six months. The study assessed the MEST-C score, demographic factors, and clinical parameters. Results: Among 52 patients with segmental glomerulosclerosis (S1), 11 (24.44%) achieved complete remission, 30 (66.67%) partial remission, and 5 (11.11%) progressed to end-stage renal disease. Inthose with tubular atrophy/interstitial fibrosis (T1), 1 (5.88%) achieved complete remission, 13(76.47%) partial remission, and 4 (23.53%) progressed to end-stage renal disease. For glomerular crescents (C1), 9 (47.37%) achieved complete remission, 9 (47.37%) partial remission, and 1 (5.26%) progressed to end-stage renal disease. IFTA% of 0-25% had complete remission in 15 (46.88%). Among the two patients with IFTA% ≥50%, one (50%) developed end stage renal disease and the other achieved partial remission. Conclusions: The S1 and T1/2 components of the MEST-C score had higher rates of partial remission and progression to end-stage renal disease, while other indices showed mixed results. The risk of failing to achieve complete increased with an IFTA of more than 25%.

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