Validating the Oxford Classification of IgA Nephropathy

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The evolution of patients with IgA nephropathy (IgAN) varies greatly, and predictive tools are needed to assess confidently the risk for progression. Although in many studies clinical risk factors such as hypertension and proteinuria have consistently been linked to outcome, the independent value of pathology remains debated. Pathologists have developed a number of classifications over the years, at times with seemingly conflicting results. In 2009, the International IgA Nephropathy Network Group, working in collaboration with the Renal Pathology Society, proposed a set of four predictive renal biopsy findings independent of clinical assessment, the MEST score (M, mesangial hypercellularity; E, endocapillary proliferation; S, segmental glomerulosclerosis/adhesion;