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

## TL;DR

The study evaluates the Japanese Renal Pathology Society classification's ability to predict kidney disease progression in Chinese patients with diabetic kidney disease.

## Contribution

The study compares the JRPS classification's prognostic value in Chinese DKD patients against the RPS classification.

## Key findings

- Higher JRPS classification grades were independently associated with adverse renal outcomes.
- The JRPS classification showed inferior discriminative performance compared to the RPS classification.
- 76.6% of patients reached renal outcomes, with 40.3% progressing to end-stage kidney disease.

## Abstract

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.

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.

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.

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.

The online version contains supplementary material available at 10.1007/s10157-025-02782-w.