Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 13 3 2024 07 17 Correlation between MEST-C score in kidney biopsy of IgA nephropathy patients with prognosis e32275 e32275 10.34172/jrip.2024.32275 EN Ellahe Sanei https://orcid.org/0000-0001-6665-8516 Abolfazl Akhond https://orcid.org/0000-0001-5592-8285 Sina Ashouri https://orcid.org/0009-0004-6554-7733 Soudeh Arastouei https://orcid.org/0000-0002-1087-9982 Indira Giri https://orcid.org/0009-0003-6979-3838 Hassan Mehrdad-Majd https://orcid.org/0000-0002-8745-6558 Malihe Saberafsharian https://orcid.org/0000-0002-0115-8016 Maryam Miri https://orcid.org/0000-0002-9962-6753 Journal Article 10.34172/jrip.2024.32275 2023 12 05 2024 03 14 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.