IgA nephropathy is the most common cause of inflammation in the filters of the kidney. Some people with the disease will develop kidney failure, a life threatening condition.
To determine those at risk of developing kidney failure, clinicians review blood pressure and urine protein levels in those with IgA nephropathy over a period of at least two years. Because of the waiting time required for this prediction, effective therapies are often delayed.
To address this issue, TGHRI Senior Scientist Dr. Daniel Cattran led a team of international experts to develop a test to predict the risk of kidney failure sooner. The team examined kidney tissue biopsy samples from those diagnosed with IgA nephropathy and they evaluated the cellular features in the samples according to a set of criteria known as the MEST score. They found that the combination of the MEST score and other clinical features collected at the same time could predict which patients would develop kidney failure, and that the approach was as accurate as using the data gathered over two years of follow-up.
"With earlier prediction of which patients will develop kidney failure, our new approach enables this patient group to be treated two years sooner," explains Dr. Cattran. "This in turn will help to prevent or slow the progression of their kidney disease."
This work was supported by the Carraresi Foundation, the Michael Smith Foundation for Health Research, the European Renal Association – European Dialysis and Transplant Association, the International IgA Nephropathy Network, the Toronto GN Registry and the Toronto General & Western Hospital Foundation..
The MEST score provides earlier risk prediction in lgA nephropathy. Barbour SJ, Espino-Hernandez G, Reich HN, Coppo R, Roberts IS, Feehally J, Herzenberg AM, Cattran DC; Oxford Derivation, North American Validation and VALIGA Consortia; Oxford Derivation North American Validation and VALIGA Consortia. Kidney International. 2016 Jan. [Pubmed abstract]