From the Guidelines
The MEST score is actually referred to as the MEST-C score, which is a histologic scoring system used to assess disease prognosis in patients with IgA nephropathy, and it includes the following components: M (mesangial hypercellularity), E (endocapillary hypercellularity), S (segmental glomerulosclerosis), T (interstitial fibrosis/tubular atrophy), and C (crescents) [ 1 ].
Key Components of MEST-C Score
- M: mesangial hypercellularity
- E: endocapillary hypercellularity
- S: segmental glomerulosclerosis
- T: interstitial fibrosis/tubular atrophy
- C: crescents The MEST-C score is used to predict the risk of progression to end-stage renal disease in patients with IgA nephropathy [ 1 ].
Management of IgA Nephropathy
The primary focus of IgA nephropathy management should be multifaceted, optimized supportive care, including RAS blockade as much as tolerated or allowed, blood pressure control, cardiovascular risk minimization, adherence to lifestyle advice, including dietary counselling, smoking cessation, weight control, and exercise as appropriate [ 1 ].
From the Research
MEST Score for IgA Nephropathy
The MEST score is a histopathologic scoring system used to predict the progression of IgA nephropathy (IgAN) [(2,3,4)]. The score is based on four types of histological lesions:
- M: Mesangial hypercellularity
- E: Endocapillary hypercellularity
- S: Segmental sclerosis
- T: Tubular atrophy/interstitial fibrosis
Prognostic Value of MEST Score
The MEST score has been shown to be a useful prognostic tool for predicting the risk of end-stage renal disease (ESRD) in IgAN patients [(2,3,5,6)]. Studies have demonstrated that patients with higher MEST scores are at increased risk of developing ESRD [(3,5,6)].
Key Findings
- The MEST score is an independent predictor of ESRD risk in IgAN patients [(2,3)]
- The score can be used to classify patients into different risk categories [(3,5,6)]
- The addition of C lesions to the MEST score does not improve its prognostic value 3
- The MEST score can be used in combination with other clinical and pathological variables to estimate ESRD risk [(5,6)]
Clinical Applications
- The MEST score can be used to predict the risk of ESRD in IgAN patients and guide clinical management [(2,3,5,6)]
- The score can be used to identify patients at high risk of disease progression and prioritize treatment [(3,4)]