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저자정보
Lim Jeong-Hoon (Kyungpook National University Daegu Republic of Korea) Han Man-Hoon (Department of Pathology School of Medicine Kyungpook National University Daegu Korea) Kim Yong-Jin (Kyungpook National University Daegu Republic of Korea) 전예나 (경북대학교) Jung Hee-Yeon (Department of Internal Medicine School of Medicine Kyungpook National University Kyungpook National) 최지영 (경북대학교) Cho Jang-Hee (Department of Internal Medicine Kyungpook National University Hospital School of Medicine Kyungpook) Kim Chan-Duck (Department of Internal Medicine School of Medicine Kyungpook National University Kyungpook National) 김용림 (경북대학교) Lee Hajeong (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kim Dong Ki (Department of Internal Medicine Seoul National University College of Medicine Seoul Republic of Kor) 문경철 (서울대학교) Park Sun-Hee (Kyungpook National University Daegu Republic of Korea)
저널정보
대한신장학회 Kidney Research and Clinical Practice Kidney Research and Clinical Practice Vol.40 No.1
발행연도
2021.1
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77 - 88 (12page)

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Background: Antineutrophil cytoplasmic antibodies (ANCA)-associated glomerulonephritis (AAGN) is a common cause of rapidly progressive glomerulonephritis and requires prompt and proper immunosuppressive therapy to improve renal prognosis. This study aimed to evaluate the predictive value of two different classifications for renal outcomes in Korean AAGN patients. Methods: Ninety-two patients who were diagnosed with AAGN at two tertiary hospitals between 2004 and 2018 were retrospectively analyzed retrospectively. The histopathologic classification according to glomerular pathology and the clinicopathologic classification according to normal glomeruli ratio, degree of interstitial fibrosis/tubular atrophy, and baseline renal function were evaluated using the Cox proportional hazards model. Results: Forty-five patients (48.9%) progressed to end-stage kidney disease (ESKD) during the observation period. The mean age was 61.0 ± 15.3 years, and most patients had myeloperoxidase-ANCA (93.5%). In the histopathologic classification, the best renal survival occurred in the focal class, whereas the sclerotic class had the worst renal survival (sclerotic class vs. focal class; adjusted hazard ratio [aHR], 5.05; 95% confidence interval [CI], 1.32–19.31; p = 0.018). The mixed class had intermediate renal outcomes (mixed class vs. focal class; aHR, 4.23; 95% CI, 1.23–14.58; p = 0.022). In the clinicopathologic classification, the high-risk group had poor renal outcomes compared with the low-risk group (aHR, 6.56; 95% CI, 1.25–34.26; p = 0.026), but renal outcomes did not differ between the low- and medium-risk groups. Conclusion: In Korean AAGN patients, histopathologic and clinicopathologic classifications had predictive value for renal outcomes, especially in the sclerotic class or the high-risk group with higher risk of progression to ESKD despite treatment.
#Antibodies #Antineutrophil cytoplasmic #Classification #Glomerulonephritis #Kidney failure #Chronic #Pathology

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참고문헌 (31)

참고문헌 신청
Jennette JC / 2013 / Pathogenesis of antineutrophil cytoplasmic autoantibody-associated small-vessel vasculitis / Annu Rev Pathol 8:139~160 google schola Jennette JC / 2013 / 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides / Arthritis Rheum 65:1~11 google schola Pettersson EE / 1995 / Incidence and outcome of pauci-immune necrotizing and crescentic glomerulonephritis in adults / Clin Nephrol 43:141~149 google schola Bajema IM / 1999 / Kidney biopsy as a predictor for renal outcome in ANCA-associated necrotizing glomerulonephritis / Kidney Int 56:1751~1758 google schola Tanna A / 2015 / Long-term outcome of antineutrophil cytoplasm antibody-associated glomerulonephritis : evaluation of the international histological classification and other prognostic factors / Nephrol Dial Transplant 30:1185~1192 google schola

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