Morphologic Markers of Progressive Immunoglobulin AÂ Nephropathy

The clinical outcome of patients with immunoglobulin A (IgA) nephropathy is highly variable, and immunosuppressive therapies used to treat progressive disease carry a high risk of toxicity. While the kidney biopsy remains essential for the diagnosis of IgA nephropathy, previous biopsy scoring systems have not been consistently integrated into clinical care. Recent rigorous efforts to describe and quantify clinically important morphologic measures of disease activity and injury have established that data gleaned from kidney biopsies provides independent prognostic information. In this article we review the recent derivation of a simplified scoring system for IgA nephropathy and discuss potential integration of pathology scores into routine clinical care.