5-fold increased risk (P < 0.001). A multicenter validation study of the Oxford classification was conducted in a cohort of 1026 patients with IgAN from China. It was found that the tubular atrophy/interstitial fibrosis (T) was the most powerful lesion for prediction of renal prognosis of IgAN independent of clinical features, while mesangial hypercellularity (M) and segmental glomerulosclerosis (S) also associated with renal survival. The predictive value of histological changes after treatment in patients with IgAN has not been established. We evaluated the changes in 99

patients with IgAN using repeat renal biopsy. Compared to the first biopsy, the percentages of glomerular endocapillary hypercellularity, crescent and learn more capillary necrosis significantly decreased at the time of the second biopsy, whereas the percentages of tubular atrophy/interstitial fibrosis increased. The resolution of glomerular crescent or capillary necrosis, but not endocapillary hypercellularity, was associated with decreased proteinuria and hematuria. Immunosuppressive therapy showed only an independent association with the resolution of glomerular crescent or capillary necrosis. The resolution or reduction of tubulointerstitial lesions was not observed. Tubular atrophy/interstitial

NVP-AUY922 fibrosis continued to progress, regardless of treatment and were associated with decreased renal function. The changes in mesangial hypercellularity and segmental glomerulosclerosis were not associated with disease progression and treatment. Altogether, these findings indicate that repeat renal biopsies in patients with IgAN could facilitate assessing the response to treatment and provide a prognostic value. Recently, a multicenter cohort study showed that crescentic

IgAN has a poor prognosis, and initial SCr concentration may predict kidney failure in patients with this disease. We conducted two clinical Methane monooxygenase trials based on the lesions of renal pathology and histological grading in patients with IgAN. 1). Corticosteroid therapy for IgA nephropathy with minimal change (MCD) lesions. Total 27 patients received prednisone in a daily dose of 1 mg/kg/day, after 8 weeks treatment, all of these patients achieved complete remission, and no severe adverse events was observed. This result supports that prednisone is an effective and safe therapy for IgAN patients with MCD lesion. 2). Mycophenolate mofeil (MMF) therapy for IgA Nephropathy with proliferative lesions. This is a multicenter, randomized and controlled clinical trial, to evaluate the effect of immunosuppressive therapy on IgAN patients with proliferative lesions (with E, C or N lesion). 140 biopsy-proven IgAN were recruited in this study, MMF treatment (MMF 1.5 g/d) for 6 moths, using prednisone (0.6 mg/kg/d) as control. All of these patients have comparable renal histological score before the treatment. The remission rate was observed in 84% of the patients in MMF group and 78% in Prednisone group.