Milivojević Danijel, Nikolić Gorana, Tampe Björn, Pecić Maja, Babac Snežana, Paripović Dušan, Miloševski Lomić Gordana, Brković Voin, Baralić Marko, Janković Aleksandar, Đurić Petar, Stajić Nataša, Putnik Jovana, Radojević Škodrić Sanja, Životić Maja
Institute of Pathology "Dr. Ðorđe Joannović", Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Department of Nephrology and Rheumatology, University Medical Center Göttingen, 37075 Göttingen, Germany.
Life (Basel). 2025 Aug 3;15(8):1231. doi: 10.3390/life15081231.
IgA nephropathy is the most common primary glomerulonephritis, with pathohistological changes described by the Oxford classification, while the Banff classification is used in transplant pathology. This study included 253 patients with IgA nephropathy in native kidneys, divided into the pediatric ( = 105) and adult ( = 148) groups. It aimed to examine clinical, and Oxford and Banff morphological parameters in relation to age, correlations of clinical data with pathohistological parameters, and predictors of the disease outcome. Pediatric patients more frequently presented with macroscopic hematuria, while adults showed higher urea and creatinine levels, and lower eGFR. Examining Oxford classification parameters, chronic glomerular and tubulointerstitial lesions were more common in adults. Banff parameters revealed more frequent chronically active glomerular, inflammatory, chronic tubulointerstitial, and vascular lesions in adults. All inflammatory, chronic tubulointerstitial, and vascular parameters correlated with serum urea levels, eGFR and CKD stage in adults, while less frequent in pediatric patients. Tubulointerstitial Oxford and Banff parameters were strong predictors of CKD and proteinuria progression in children, while such predictors were fewer in adults; segmental glomerulosclerosis predicted hematuria progression in adults. Banff parameters (cg, t, ti, i, i-IFTA, ptc, cv), not in Oxford classification, significantly predict outcomes and are recommended for incorporation into IgA nephropathy reports.
IgA肾病是最常见的原发性肾小球肾炎，其病理组织学改变采用牛津分类法描述，而移植病理学中则使用班夫分类法。本研究纳入了253例原发性IgA肾病患者，分为儿童组（n = 105）和成人组（n = 148）。旨在研究临床、牛津和班夫形态学参数与年龄的关系、临床数据与病理组织学参数的相关性以及疾病预后的预测因素。儿童患者更常出现肉眼血尿，而成人患者的尿素和肌酐水平较高，估算肾小球滤过率（eGFR）较低。在检查牛津分类参数时，慢性肾小球和肾小管间质病变在成人中更为常见。班夫参数显示成人中慢性活动性肾小球、炎症、慢性肾小管间质和血管病变更为频繁。所有炎症、慢性肾小管间质和血管参数在成人中均与血清尿素水平、eGFR和慢性肾脏病（CKD）分期相关，而在儿童患者中相关性较低。肾小管间质牛津和班夫参数是儿童CKD和蛋白尿进展的强预测因素，而成人中的此类预测因素较少；节段性肾小球硬化预测成人血尿进展。班夫参数（cg、t、ti、i、i-IFTA、ptc、cv）不在牛津分类中，可显著预测预后，建议纳入IgA肾病报告中。
