The Joint Committee of the Research Group on Progressive Renal Disease for the Ministry of Health and Welfare of Japan and the Japanese Society of Nephrology have reported a histologic grading system for IgA nephropathy.
Patient selection: IgA nephropathy
Exam: histologic review of renal biopsy
Glomerular Findings:
(1) mesangial cell proliferation and matrix
(2) glomerulosclerosis, crescents, and/or adhesions with Bowman's capsule
Interstitial and Vascular Findings:
(1) interstitial cellular infiltrate
(2) tubular atrophy
(3) vascular sclerosis
Mesangial Changes
Glomerulosclerosis, Crescents, and/or Adhesions to Bowman's Capsule
Grade
none or slight
none or rare
I
none or slight
< 10% of glomeruli
II
moderate, diffuse
10-30% of glomeruli
III
severe, diffuse
> 30% of glomeruli. Some glomeruli show compensatory hypertrophy
IV
Interstitial Cellular Infiltrate
Tubular Atrophy
Vascular Change
Grade
no prominent changes
no prominent changes
no prominent changes
I
no prominent changes
no prominent changes
no prominent changes
II
slight
slight
mild vascular sclerosis
III
moderate to marked; variable fibrosis
moderate to marked
moderate to marked
IV
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