Factors associated with the outcomes of ANCA-associated glomerulonephritis: a retrospective cohort study
Background. Kidney involvement is one of the prognostically significant manifestations of ANCA-associated vasculitis (AAV). The aim of the study was to evaluate factors associated with kidney survival in patients with biopsy proven ANCA-associated glomerulonephritis (ANCA-GN). Materials and metho...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
"Consilium Medicum" Publishing house
2025-01-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/657483/202482 |
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| Summary: | Background. Kidney involvement is one of the prognostically significant manifestations of ANCA-associated vasculitis (AAV). The aim of the study was to evaluate factors associated with kidney survival in patients with biopsy proven ANCA-associated glomerulonephritis (ANCA-GN).
Materials and methods. Patients with AAV and biopsy proven pauci-immune extracapillary glomerulonephritis who underwent in-hospital and/or outpatient management between 2014 and 2024. AAV was diagnosed in accordance with the ACR classification criteria (2022) and the Chapel Hill Consensus Conference definitions (2012). The primary end-point was time from kidney biopsy to chronic kidney disease according to the KDIGO 2024 definition. Estimated GFR was calculated using CKD-EPI 2021 equation using serum creatinine concentration. Cox proportional hazards model and binary logistic regression were used to identify factors associated with outcomes.
Results. A total of 91 patients were included in the study, including 56 (62%) women. The median age of AAV onset was 50 (35; 58) years and the median duration of follow-up was 40 (14; 66) months. CKD G5 developed in 21 (23%) patients, 19 of them required kidney replacement therapy. Meanwhile, a total of 70 (77%) patients fell into high and very high risk groups according to the KDIGO CKD classification. Factors associated with adverse kidney outcome that confirmed their statistical significance in multivariate models were ARRS high-risk group and AKRiS very high-risk group, dialysis dependance at the time of biopsy, and initial oral glucocorticoid dose 30 mg/day. Female sex was associated with a lower risk of adverse kidney outcome.
Conclusion. The outcomes of ANCA-GN remain unfavourable. Occurrence of CKD G5 is associated with ARRS and AKRiS risk groups, dialysis dependance at the time of biopsy, and low glucocorticoid dose. |
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| ISSN: | 0040-3660 2309-5342 |