Abstract
The Oxford classification of immunoglobulin A nephropathy (IgAN) was proposed to establish the risk of renal disease progression by specific pathologic features. This classification needs validation in different populations. A total of 126 patients with biopsy-proven IgAN at Ramathibodi Hospital between 2003 and 2012 with GFR above 30mL/min/1.73m<sup>2</sup> were enrolled in this retrospective study. The renal outcome was defined as the composite of 50% reduction in GFR and end state renal disease (ESRD). The Oxford classification was used to evaluate the pathologic lesions. The predictive values of clinicopathologic risk factors on renal survival were analyzed by univariate and multivariate models. The renal outcome occurred in 37 patients with median follow-up time of 49 months. Median renal survival was 121 months. In univariate time dependent analyses, only tubular atrophy/interstitial fibrosis was significantly associated with renal outcome. Other features such as crescentic lesions, mesangial hypercelluarity, endocapillary hypercelluarity, segmental glomerulosclerosis were not significant. In multivariate model, tubular atrophy/interstitial fibrosis (T1: HR 6.88, 95% CI 0.50–05.19; T2: HR 8.58, 95% CI 1.34–54.82) were independent risk factor for renal outcome. We confirmed that tubulointerstitial features of the Oxford classification of IgAN can predict renal survival in the Thai population.
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