Oxford Classification of IgA Nephropathy
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Developed to provide a reproducible histopathologic scoring system correlated with prognosis.
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Based on renal biopsy findings.
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Uses the MEST-C score:
| Letter | Feature | Scoring |
|---|---|---|
| M | Mesangial hypercellularity | M0: ≤50% of glomeruli have >4 mesangial cells; M1: >50% of glomeruli have >4 mesangial cells |
| E | Endocapillary hypercellularity | E0: absent; E1: present |
| S | Segmental glomerulosclerosis | S0: absent; S1: present |
| T | Tubular atrophy/interstitial fibrosis | T0: 0–25%; T1: 26–50%; T2: >50% |
| C | Crescents (added later) | C0: none; C1: crescents in <25% glomeruli; C2: crescents in ≥25% glomeruli |
response to therapy C and E
T protends prognosis
IgA nephropathy
ACE and SGLT2 inhibitor
clinical prognosticating factor- proteinuria
1 gram cut point
cut point if you get less than 300 even better
above one gram below one gram
IgA can present as nephrotic syndrome
crescentic IgA and nephrotic syndrome
can use steroids
lower dose steroids
endocapillary proliferation
steroids
targetted release budesonide
nephro con
STOP IGA risk of infections
risk of steroids fell out of favor
sparsentan which is endothelin and angiotensin 2 receptor blocker
factor b
talk about complement
kidigo
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