CORRELATION OF OXFORD MEST-C SCORES WITH CLINICAL-BIOCHEMICAL VARIABLES IN IGA NEPHROPATHY-A RETROSPECTIVE STUDY
Main Article Content
Keywords
Kidney, Biopsy, Hypertension, Renal Failure.
Abstract
Background
IgA Nephropathy is most common primary glomerulopathy reported worldwide. It presents with varied features. MEST-C is used to score histopathology in IgA nephropathy. M stands for Mesangial hypercellularity, E stands for Endocapillary hypercellularity, S stands for Segmental glomerulosclerosis, T stands for Tubular atrophy/interstitial fibrosis, C stands for crescents. As IgA nephropathy is diagnosed in advanced stage in South India, there is deficient data on direct correlation between MEST-C score in kidney biopsy with clinical stage of disease. This study can help in prognostication of the disease in renal outcome by adding MEST-C score to clinical data available at the time of kidney biopsy. There is paucity of data on correlation of Oxford MEST-C scores with clinical-biochemical variables in IgA Nephropathy. Hence, this study was conducted to gain this information.
Methods
It was a retrospective observational study conducted to assess the correlation of Oxford MEST-C scores in kidney biopsy with clinical-biochemical variables in total of 53 kidney biopsy proven IgA Nephropathy patients among the total of 501 total kidney biopsies done. This study was conducted using medical records of IgA nephropathy diagnosed patients. Data was collected regarding patient’s demography, clinical features, biochemical parameters and kidney biopsy histopathological findings. Data analysis regarding correlation between clinical-biochemical parameters and MEST-C score in kidney biopsy findings was assessed.
Results
It was found that all M,E,S,T,C scores were significantly linked to presence of renal failure and so, with poor renal outcome, though higher scores T(1,2), C(C2) were significantly noted with presence of renal failure. M,C scores were significantly linked to presence of hypertension. S score was linked to presence of nephrotic proteinuria. S, T scores were linked to microscopic hematuria. C score was linked to macroscopic hematuria.Chronicity was linked to presence of renal failure and macroscopic hematuria. IgA staining was found to localize more in mesangial/paramesangial areas, had strong association with M,E,S,C scores and C3 staining. Among light chain staining, it was found that Lambda chain staining was dominant.
In this study, patients were younger, had greater prevalence of hypertension, nephrotic proteinuria, advanced renal failure on presentation unlike to data quoted in western literature as in Swarnaltha Gowrishankar et al study.
Conclusions
MEST-C score correlated with various clinical features of IgA nephropathy significantly, which may help in prognostication of the disease.
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Dr. Girish P. Vakrani
Professor & HOD, Department of Nephrology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
Dr. Nambakam Tanuja Subramanyam
Professor, Department of General Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
Dr. Priyashree R
Assistant Professor, Department of Nephrology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
Dr Yashavantha kumar K.Y.
Consultant Nephrologist, Narayana Multispeciality Hospital, Mysore, Karnataka, India.