ESPN 51th Annual Meeting

ESPN 2018


 
Is Oxford Classification of IgA Nephropathy Helpful in Predicting Outcome in children with Henoch–Schönlein Purpura Nephritis
NURDAN YILDIZ 1 MEHTAP SAK 1 DENIZ FILINTE 2 NESLIHAN ÇIÇEK 1 İBRAHIM GÖKÇE 1 HARIKA ALPAY 1

1- MARMARA UNIVERSITY MEDICAL SCHOOL, SB PENDIK RESEARCH HOSPITAL, DIVISION OF PEDIATRIC NEPHROLOGY
2- MARMARA UNIVERSITY MEDICAL SCHOOL, SB PENDIK RESEARCH HOSPITAL, DIVISION OF PATHOLOGY
 
Introduction:

  In Henoch-Schönlein purpura nephritis (HSPN), grading the renal biopsy according to the classical International Study of Kidney Disease in Children (ISKDC) may not always reflect the severity of the disease and long-term prognosis. Considering the clinical and histopathological similarities between HSPN and IgA nephropathy, the Oxford classification of IgA nephropathy may be useful in predicting the outcome of HSPN. Thus, we aimed to evaluate the value of the Oxford classification to assess the clinical presentation and outcome.

Material and methods:

The biopsy specimens of the patients who had HSPN and underwent kidney biopsy reevaluated retrospectively and reclassified according to ISKDC and Oxford classification by the same pathologist. The relationship between remission of proteinuria, estimated glomerular filtration rate (eGFR) and classification scores were analyzed.    

Results:

 We evaluated 28 renal biopsy specimens of the patients (18 males, 10 females) with HSPN. The mean age of the patients at presentation and the mean follow-up times were 8.8±3.4 (2.7-17.3) and 2.8±2.3 (0.1-9.4) years, respectively.  Proteinuria and crescent formation showed significant correlation with ISKDC classification (p=0.015 and p=0.16), however we did not find any relation between the proteinuria and Oxford classification parameters. Estimated GFR is significantly correlated with crescent formation (p=0.02) and proteinuria (p=0.04). There was no relation between the Oxford classification and high-dose methylprednisolone (hdMP) treatment. However, according to the ISKDC classification, the majority of stage 5 patients received hdMP treatment. 

Conclusions:

 Our findings suggest that the Oxford classification can be used in children with HSPN, but no significant superiority to ISKDC was observed. We need larger series to assess the validty of the Oxford classification.