Abstract
ABSTRACT Background and aims: The goal of this study was to assess the diagnostic value of the new International Society of Nephrology‐Renal Pathology Society (ISN‐RPS) classification system for lupus nephritis (LN). Methods: We reviewed 170 biopsy specimens according to the WHO and the ISN‐RPS systems. Results: The frequencies of class I, class II, class III, class IV, class V, and class VI LN for the WHO/ISN‐RPS systems were 0.6%/1.8%, 2.4%/2.4%, 28.2%/24.7%, 52.4%/60%, 14.7%/9.4%, and 1.8%/1.8%, respectively. Class‐switch events occurred in 22 cases, with 12 cases switched from class III under the WHO system to class IV under the ISN‐RPS system. Class IV‐S LN showed a higher frequency of fibrinoid necrosis than IV‐G LN (P = 0.003), but endocapillary proliferation was more pronounced in class IV‐G than class IV‐S (P = 0.003). The frequency of coexistent class V LN was higher in class III LN than class IV LN (P = 0.008). The interobserver reproducibility of the ISN/RPS system was better (κ = 0.76) than that of the WHO system (κ = 0.33). Conclusions: Interobserver reproducibility for the ISN‐RPS system for lupus nephritis is greater than for the WHO system. The prognostic value of class IV‐S, IV‐G, and coexistent class V should be verified by future study.
Published Version
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