Prognostic assessment of the Japanese Renal Pathology Society classification in Chinese patients with histologically confirmed diabetic kidney disease.

BACKGROUND

This study aimed to comparatively evaluate the prognostic value of the Japanese Renal Pathology Society (JRPS) classification for predicting diabetic kidney disease (DKD) progression in Chinese patients.

METHODS

This retrospective cohort study included 124 patients diagnosed with DKD from 2014 to 2020. Patients were classified into four JRPS classification grades based on the J-score. Renal survival was assessed using Kaplan-Meier analysis and Cox regression, and predictive accuracy was compared with the RPS classification and total renal chronicity score using receiver operating characteristic (ROC) curve analysis and the DeLong test.

RESULTS

Over a median follow-up of 37 months, 76.6% of patients reached renal outcomes, including 40.3% progressing to end-stage kidney disease (ESKD). Higher JRPS classification grades were independently associated with adverse renal outcomes. However, ROC analysis demonstrated that the JRPS classification exhibited inferior discriminative performance compared with the traditional RPS classification system.

CONCLUSION

The JRPS classification was independently associated with renal outcomes but showed inferior discriminatory performance compared with the RPS classification. These findings suggest that JRPS classification may provide complementary pathological information rather than serving as a primary prognostic tool.