Yang X, Ou J, Zhang H, et al. - In this prospective observational cohort analysis in China, researchers evaluated the ability of urinary matrix metalloproteinase 7 (MMP-7) in predicting immunoglobulin A nephropathy (IgAN) progression, and they also determined if an improved risk prediction can be obtained by its addition to clinical data at the time of biopsy. The training set comprised of 554 Chinese patients having IgAN and observed for a median of 40 months in 1 clinical center, and the validation set included 392 Chinese patients with IgAN observed for 28 months in a second clinical center. A composite of > 40% loss of estimated glomerular filtration rate, kidney failure, or mortality, defined IgAN progression. In this study, the urinary MMP-7 level was identified as an independent predictor of IgAN progression. The risk prediction of IgAN progression was significantly improved as a result of the addition of urinary MMP-7 level to MEST-C score and clinical data at the time of biopsy.