Is it possible to predict the evolution of IgAN? Validation of the IgA nephropathy progression calculator and its relationship with MEST-C score in our population

Abstract

Introduction: IgA nephropathy (IgAN) is the most common and heterogeneous glomerular nephropathy. Several strategies have been used to determine the risk of progression to ESRD. We evaluate the prognostic significance and correlate the IgAN progression calculator (IgANPC) and the Oxford/MEST-C score in our population. Material and methods: We performed a retrospective study of biopsied patients with diagnosis of IgA nephropathy from 1990 to 2015. We classified the biopsies using MEST-C score and we correlated the score to clinical evolution. We also calculated the risk of progression with the online IgANPC at the time of the biopsy. Results: We analyzed 48 biopsies, 83% of which were men with a mean age of 45 years at the time of the biopsy.Patients with a biopsy E1 according to MEST-C score had a higher IgANPC score than those with E0 (p = .021).The Pearson's correlation for the percentage of crescents and the IgANPC risk score was statistically significant (p = .014) with r = 0.357.The percentage of patients with eGFR above 30 ml/min at 10 years was 100% for the low-risk group (group 1 of IgANPC), and 0% for the high-risk group (group 3), log rank p = 0.001.The log rank comparison for variables of the MEST-C score, presented statistically significant results between E (0.036) and S (0.022) and the eGFR time 30 ml/min a 10 años, mientras que ninguno de los del grupo 3 presenta un FGe > 30 ml/min a 10 años (p = 0,001).La comparación de log rank para variables del MEST-C score presenta resultados estadísticamente significativos entre E (0,036) y S (0,022), y el tiempo a FGe < 30 ml/min.También se observa una relación estadísticamente significativa entre T1 y FGe < 30 ml/min.El análisis multivariante con la regresión de Cox para IgANPC y FGe< 30 ml/min muestra una fuerte correlación (p = 0,016) entre el grupo de riesgo y FGe < 30 ml/min. Conclusión: IgANP predice el tiempo hasta FGe < 30 ml/min y añade información independiente del MEST.La clasificación de MEST-C score y el IgANPC score son útiles e independientes para la predicción pronóstica; queda validar su uso en la población general. Keywords: IgA nephropathy, Prognostic prediction tools, Oxford score (MEST-C), IGA Nephropathy Prognostic Calculator, Palabras clave: Nefropatía IgA, Herramientas de predicción pronóstica, Oxford score (MEST-C), IGA Nephropathy Prognostic Calculator