A Single-Center Retrospective Cohort Study on the Correlation between the Oxford Classification of IgA Nephropathy Based on Multimodal Pathological Features and Clinical Prognosis
- 1 Department of Nephrology, Baise Peoples Hospital/Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, China
- 2 Department of Nephrology, Baise Peoples Hospital/Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, China
- 3 Department of Nephrology, Baise Peoples Hospital/Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, China
- 4 Department of Nephrology, Baise Peoples Hospital/Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, China
- 5 Department of Nephrology, Baise Peoples Hospital/Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, China
- 6 Department of Nephrology, Baise Peoples Hospital/Affiliated Southwest Hospital of Youjiang Medical University for Nationalities, Baise, China
Abstract
Objective: To explore the intrinsic relationship between the Oxford Classification (MEST-C) of IgA Nephropathy (IgAN) and patients’ baseline clinical indicators, combined with multimodal pathological findings. Methods: Clinical and pathological data from 40 patients with primary IgAN diagnosed by renal biopsy at our hospital between April 2021 and December 2024 were retrospectively collected. Pathological presentations, including the Oxford Classification, immunofluorescence deposition patterns, and electron microscopy features, were analyzed and correlated with clinical indicators such as 24-hour urine protein (24 hUP), estimated glomerular filtration rate (eGFR), and hypertension. Results: Among the 40 patients, the M1 (95.0%) and S1 (77.5%) scores of the Oxford Classification were the most prevalent. Correlation analysis between pathology and clinical indicators showed that in the patient group with global glomerulosclerosis ≥ 25%, the proportions of 24 hUP ≥ 1 g, eGFR < 60 ml/min/1.73m 2 , and concomitant hypertension were 85.0%, 75.0%, and 85.0%, respectively, all higher than those in the group with global glomerulosclerosis < 25% (55.0%, 35.0%, 45.0%). The incidence of adverse clinical indicators was also higher in groups with tubular atrophy/interstitial fibrosis (T lesions) ≥ 25% and the presence of crescents (C lesions). As the Lee grade increased, the proportions of T1-T2 and C1-C2 lesions showed a significant increasing trend, reaching 100% for both lesion types in Grade V patients. Conclusion: The T and C lesions in the Oxford Classification of IgAN are closely associated with adverse clinical indicators, including higher levels of proteinuria and lower eGFR. The multimodal pathological evaluation model, particularly the standardized application of the Oxford Classification, holds significant clinical value for accurately assessing the severity of IgAN.
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