International IgA Nephropathy Prediction Tool
Predicts 50% eGFR decline or end-stage renal disease in IgA nephropathy at 5 and 20 years. Combines clinical and histological (Oxford MEST-C) criteria.
Score interpretation
Low risk of ESKD — <30% risk of 50% eGFR decline at 20 years
→ Optimise BP (<130/80 with RAS blockade); reduce proteinuria (<0.5 g/day target with ACEi/ARB); repeat eGFR and uPCR every 6 months
Intermediate risk of ESKD
→ Maximum RAS blockade; SGLT-2 inhibitor (sparsentan or dapagliflozin approved for IgA nephropathy); consider corticosteroids for persistent proteinuria >1 g/day; nephrology specialist follow-up
High risk of ESKD — >50% risk of significant decline within 10–20 years
→ Aggressive nephroprotection; corticosteroid therapy (Supportive Immunosuppressive Therapy for IgA Nephropathy/STOP-IgAN regimen); consider novel agents (budesonide-targeted release/Nefecon); transplant planning early
Interpretation bands for the IgA Nephropathy Risk. Apply clinical judgement and local guidance.
References
- Barbour SJ et al. The MEST score provides earlier risk prediction in IgA nephropathy. Kidney Int. 2016;89(1):167–175.
Related
Curated clinical cross-links plus same-class fallbacks.
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Zinc acetate · Zinc salt (Wilson's disease)
- Sulfasalazine · Aminosalicylate / Disease-Modifying Antirheumatic Drug (DMARD)
- Hydroxycarbamide (Hydroxyurea) · Cytoreductive agent / Sickle cell disease / CML
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.