Oxford-MEST classification in IgA nephropathy patients: A report from Iran

J Nephropathol. 2012 Apr;1(1):31-42. doi: 10.5812/jnp.7. Epub 2012 Apr 5.


Background: There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region.

Objectives: The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory.

Patients and methods: At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system.

Results: In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females . Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001).

Conclusions: Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease.In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system.

Keywords: Classification; Glomerulosclerosis; IgA nephropathy; Interstitial fibrosis; Proliferation; Tubular atrophy.