The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility.
Pathological classifications in current use for the assessment of glomerular disease have been typically opinion-based and built on the expert assumptions of renal pathologists about lesions historically thought to be relevant to prognosis. Here we develop a unique approach for the pathological clas...
| Published in: | Kidney International Vol. 76; no. 5; pp. 546 - 557 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
Elsevier B.V.
Sep2009
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105406244&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105406244 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00852538 4CU jtl: Kidney International issn: 00852538 maglogo: N pubinfo: dt: Sep2009 vid: 76 iid: 5 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 105406244 2010370021 10.1038/ki.2009.168 NLM19571790 105406244 ppf: 546 ppct: 11 formats: tig: atl: The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. aug: au: Roberts IS Cook HT Troyanov S Alpers CE Amore A Barratt J Berthoux F Bonsib S Bruijn JA Cattran DC Coppo R D'Agati V D'Amico G Emancipator S Emma F Feehally J Ferrario F Fervenza FC Florquin S Fogo A sug: subj: Glomerulonephritis Classification Glomerulonephritis Pathology Kidney Pathology Biopsy Kidney Glomerulus Pathology Necrosis Reproducibility of Results Human ab: Pathological classifications in current use for the assessment of glomerular disease have been typically opinion-based and built on the expert assumptions of renal pathologists about lesions historically thought to be relevant to prognosis. Here we develop a unique approach for the pathological classification of a glomerular disease, IgA nephropathy, in which renal pathologists first undertook extensive iterative work to define pathologic variables with acceptable inter-observer reproducibility. Where groups of such features closely correlated, variables were further selected on the basis of least susceptibility to sampling error and ease of scoring in routine practice. This process identified six pathologic variables that could then be used to interrogate prognostic significance independent of the clinical data in IgA nephropathy (described in the accompanying article). These variables were (1) mesangial cellularity score; percentage of glomeruli showing (2) segmental sclerosis, (3) endocapillary hypercellularity, or (4) cellular/fibrocellular crescents; (5) percentage of interstitial fibrosis/tubular atrophy; and finally (6) arteriosclerosis score. Results for interobserver reproducibility of individual pathological features are likely applicable to other glomerulonephritides, but it is not known if the correlations between variables depend on the specific type of glomerular pathobiology. Variables identified in this study withstood rigorous pathology review and statistical testing and we recommend that they become a necessary part of pathology reports for IgA nephropathy. Our methodology, translating a strong evidence-based dataset into a working format, is a model for developing classifications of other types of renal disease. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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