What MEST-C scores predict ESRD progression in IgAN?

M1 (mesangial score >0.5): worse prognosis; E1 (any endocapillary proliferation): worse; S1 (any segmental sclerosis): worse; T1 (tubular atrophy/interstitial fibrosis 26-50%): worst prognosis; T2 (>50%): ESRD within 10 years in majority; C (crescents) adds acute activity score.

What proteinuria target reduces IgAN progression?

Proteinuria target <0.5 g/day (ideally <0.3 g/day) with ACEi/ARB-based BP control <125/75 mmHg; TESTING and STOP-IgAN trial data support targeted proteinuria reduction; sparsentan achieves greater proteinuria reduction than irbesartan.

What is the evidence for budesonide in IgAN?

Targeted release budesonide (Nefecon/Tarpeyo) reduces IgA immune complex formation at gut-associated lymphoid tissue; NEFIGAN trial: 30-45% proteinuria reduction; approved for IgAN with proteinuria >1 g/day and eGFR >35 mL/min.

When should kidney biopsy be performed in IgAN?

Biopsy indicated for: proteinuria >1 g/day, unexplained hematuria + proteinuria, declining GFR; Oxford MEST-C classification guides immunosuppression decision; biopsy essential for Henoch-Schönlein nephritis classification.

What complement pathway is targeted in emerging IgAN therapies?

Complement pathway activation (MASP-2, alternative pathway, C3) drives IgAN inflammation; iptacopan (factor B inhibitor), cemdisiran (C3 siRNA), and MASP-2 antibodies are in trials; target the lectin complement pathway activated by galactose-deficient IgA1.

IgA Nephropathy Oxford MEST-C Score and Progression Risk

Calculates the Oxford MEST-C pathological classification (Mesangial hypercellularity, Endocapillary hypercellularity, Segmental glomerulosclerosis, Tubular atrophy, Crescents) for IgA nephropathy prognosis and sparsentan/budesonide eligibility.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How to Use

Enter the values for the scenario you are assessing. Calculates the Oxford MEST-C pathological classification (Mesangial hypercellularity, Endocapillary hypercellularity, Segmental glomerulosclerosis, Tubular atrophy, Crescents) for IgA nephropathy prognosis and sparsentan/budesonide eligibility. Use the igan mest-c score result to inform your calculation.

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