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Submitted: 05 Dec 2023
Accepted: 14 Mar 2024
ePublished: 28 Apr 2024
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J Renal Inj Prev. 2024;13(3): e32275.
doi: 10.34172/jrip.2024.32275
  Abstract View: 633
  PDF Download: 170

Original

Correlation between MEST-C score in kidney biopsy of IgA nephropathy patients with prognosis

Ellahe Sanei 1 ORCID logo, Abolfazl Akhond 2 ORCID logo, Sina Ashouri 3 ORCID logo, Soudeh Arastouei 4 ORCID logo, Indira Giri 5 ORCID logo, Hassan Mehrdad-Majd 6 ORCID logo, Malihe Saberafsharian 7 ORCID logo, Maryam Miri 8* ORCID logo

1 Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Innovative Medical Research Center, Faculty of Medicine, Mashhad Medical Science, Islamic Azad University, Mashhad, Iran
3 Medical Research Committee, Faculty of Medicine, Mashhad Medical Science, Islamic Azad University, Mashhad, Iran
4 Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
5 Purdue University Global, Indiana, USA
6 Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
7 Faculty of Medicine, Azad University of Medical Sciences, Mashhad, Iran
8 Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
*Corresponding Author: Maryam Miri, Email: mirighm@mums.ac.ir, Email: marmar5918@gmail.com

Abstract

Introduction: IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis, and is the most common type of glomerulopathy which leading to end-stage renal disease (ESRD). Prompt diagnosis of high-risk patients is important to initiate specific treatment early and prevent progression to ESRD. Oxford pathological classification, known as MEST-C score, attempts to predict prognosis based on pathological factors.

Objectives: In this study, we evaluated the value of pathological and clinical variables in estimating the prognosis of IgAN in Iranian patients.

Patients and Methods: In this retrospective cohort study, 165 specimens were reviewed by a nephropathologist, who reported the MEST-C score after the definitive diagnosis of IgAN. Patient records were reviewed to gather clinical data, including serum creatinine, 24-hour urine protein levels, diagnosis of hypertension and/or diabetes, and any treatment received. The pre-specified endpoints were determined as progression to ESRD, a reduction in estimated glomerular filtration rate (eGFR) to less than 50% of its baseline, performance of renal transplant, or death. The variables were compared in patients who had reached the pre-specified endpoints and those who had not, to estimate their prognostic value.

Results: Findings showed that the urinary protein level and T-score on biopsy were significant prognostic factors. Other pathological factors such as C, S, and M scores lost their significance on multivariate analysis. Further research is needed to validate the efficacy of the MEST- C score in different racial populations.

Conclusion: In our study, urinary protein level at diagnosis and T-score on biopsy were validated as prognostic factors, while M, E, S and C scores were not deemed significant. Further research is necessary to validate the MEST-C scoring system in different populations before its use in routine clinical practice.


Implication for health policy/practice/research/medical education:

IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis. The Oxford pathological classification, known as MEST-C score, is designed to predict prognosis of IgAN based on pathological factors. This study pointed out that only urinary protein level at diagnosis and T-score on biopsy could predict IgAN prognosis.

Please cite this paper as: Sanei E, Akhond A, Ashouri S, Arastouei S, Giri I, Mehrad-Majd H, Saberafsharian M, Miri M. Correlation between MEST-C score in kidney biopsy of IgA nephropathy patients with prognosis. J Renal Inj Prev. 2024; 13(3): e32275. doi: 10.34172/jrip.2024.32275.

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