التفاصيل البيبلوغرافية
| العنوان: |
ANCA serotype and histopathological classification for the prediction of renal outcome in ANCA-associated glomerulonephritis. |
| المؤلفون: |
Quintana, Luis F., Peréz, Nuria S., De Sousa, Erika, Rodas, Lida M., Griffiths, Meryl H., Solé, Manel, Jayne, David |
| المصدر: |
Nephrology Dialysis Transplantation; Sep2014, Vol. 29 Issue 9, p1764-1769, 6p |
| مصطلحات موضوعية: |
GLOMERULONEPHRITIS, NEUTROPHILS, CYTOPLASM, HEALTH outcome assessment, PREDICTION models, HISTOPATHOLOGY |
| مستخلص: |
Background The phenotype of renal involvement in anti-neutrophil cytoplasmic antibodies (ANCA) vasculitis has a major influence on survival, and histological subgrouping of diagnostic renal biopsies has been proposed to aid in the prediction of renal outcome. We aimed to validate this histological subgrouping and to investigate the additional value of ANCA serotype in the prediction of renal outcome. Methods Data were retrospectively collected from the time of diagnosis by systematic review of medical records from 136 patients with renal biopsies recruited to cohorts from the UK and Spain, over 15 years. The end point, renal survival, was the composite of end-stage renal disease (ESRD) or death from any cause. The occurrence of ESRD, Stage 4 Kidney Disease Outcomes Quality Initiative-Chronic Kidney Disease, was assessed separately, in order to establish a severity index risk of chronic kidney disease. Results Renal survival at 5 years was 96% in the focal, 86% in the crescentic, 81% in the mixed and 61% in the sclerotic subgroups (P = 0.03). Myeloperoxidase (MPO)-ANCA was associated with more severe disease when compared with PR3-ANCA, as demonstrated by a lower frequency of focal and higher frequency of sclerotic subgroups, by more advanced interstitial fibrotic change and by lower glomerular filtration rate at diagnosis and worse renal function at 1 and 2 years. Conclusions We have confirmed the predictive value for renal survival of the ANCA vasculitis histology classification in a multi-centre study. We found a worse renal outcome in patients with tubulointerstitial fibrosis and atrophy. MPO-ANCA positive patients had a worse renal prognosis due to more severe glomerular injury. These results contribute to patient stratification in renal vasculitis for therapeutic, epidemiological and basic research. [ABSTRACT FROM AUTHOR] |
|
Copyright of Nephrology Dialysis Transplantation is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder