Predictors of renal outcome in ANCA-assosiated glomerulonephritis

Backgraund/Aim. Primary anti-neutrophil cytoplasmatic antibody (ANCA)-associated vasculitis are chronic multisystemic autoimmune diseases which include microscopic polyangitis (MPA), granulomatosis with polyangitis (WG), eosinophilic granulomatosis with polyangitis (EPGA; churg-strauss syndrome – CS...

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Main Authors: Ljubičić Bojana, Azaševac Tijana, Popović Milica, Živković Siniša, Božić Dušan, Ćelić Dejan
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900135L.pdf
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author Ljubičić Bojana
Azaševac Tijana
Popović Milica
Živković Siniša
Božić Dušan
Ćelić Dejan
author_facet Ljubičić Bojana
Azaševac Tijana
Popović Milica
Živković Siniša
Božić Dušan
Ćelić Dejan
author_sort Ljubičić Bojana
collection DOAJ
description Backgraund/Aim. Primary anti-neutrophil cytoplasmatic antibody (ANCA)-associated vasculitis are chronic multisystemic autoimmune diseases which include microscopic polyangitis (MPA), granulomatosis with polyangitis (WG), eosinophilic granulomatosis with polyangitis (EPGA; churg-strauss syndrome – CSS), and also a localized forms of ill-ness. In our research, we studied clinical and serological parameters in patients, in order to find out which of them would be the best predictor of renal outcome in ANCA-associated vasculitis. Methods. Data from 42 patients with diagnose of MPA (9), WG (17), EPGA (0), CSS (0), and al-so idiopathic rapidly progressive glomerulonephritis (ROEB) without immune deposits (renal-limited vasculitis – 16) were analyzed. Cockroft formula was used for calculating the glomerular filtration in the moment of presenting the illness, and also after five year follow-up period. Other factors that were analyzed are: gender, age, type of ANCA antibodies, type of infections, stage of chronic kidney dis-ease, need for heamodialysis and mortality. Results. Of a total of 42 patients, 17 (40.48%) were male. The average age of the patients at the time of diagnosis was 57.8 (± 10.44) years. Seventeen patients (40.48%) had a diagnosis of WG, 9 (21.43%) MPA, and 16 (38.09%) iRPGN. The presence of positive anti-proteinase (anti-PR3) antibodies was confirmed i n 1 8 patients, a nd a nti-MPO antibodies in 17 patients. Three patients had both subtypes of ANCA antibodies (anti-PR3 and anti-MPO). Initially, 12 patients required heamodialysis treatment. Twenty nine patients had a complete and 13 patients had partial remission. Out of the total number of patients, 8 patients (19.04%) developed the terminal renal failure stage, and ended up on a chronic dialysis program. During a five-year follow-up period, 12 patients (28.57%) resulted in death. The age of the patient proved to be statistically significant predictor of glomerular filtration rate (GFR) at the moment of presentation of the disease (p = 0.011). GFR t = 0 was statistically significant (p = 0.000) for the evaluation of kidney function outcomes in ANCA-associated glomerulonephritis. Conclusion. Kidney function in the moment of illness presentation, determined by GFR t = 0, is the most important significant factor for predicting renal outcome in ANCA-associated vasculitis, and also the mortality in these patients.
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spelling doaj-art-d5d75ae4644f496493948cd8e34d375c2025-08-20T02:04:09ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178776977410.2298/VSP190903135L0042-84501900135LPredictors of renal outcome in ANCA-assosiated glomerulonephritisLjubičić Bojana0Azaševac Tijana1Popović Milica2Živković Siniša3Božić Dušan4Ćelić Dejan5Clinical Centre of Vojvodina, Emergency Centre, Department of Emergency Internal Medicine, Novi Sad, SerbiaClinical Centre of Vojvodina, Emergency Centre, Clinic for Nephrology and Clinical Immunology, Novi Sad, SerbiaClinical Centre of Vojvodina, Emergency Centre, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Department of Internal Medicine, Novi Sad, Serbia Clinical Centre of Vojvodina, Emergency Centre, Clinic for Nephrology and Clinical Immunology, Novi Sad, SerbiaClinical Centre of Vojvodina, Emergency Centre, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Department of Internal Medicine, Novi Sad, Serbia Clinical Centre of Vojvodina, Emergency Centre, Clinic for Nephrology and Clinical Immunology, Novi Sad, Serbia + University of Novi Sad, Faculty of Medicine, Department of Internal Medicine, Novi Sad, Serbia Backgraund/Aim. Primary anti-neutrophil cytoplasmatic antibody (ANCA)-associated vasculitis are chronic multisystemic autoimmune diseases which include microscopic polyangitis (MPA), granulomatosis with polyangitis (WG), eosinophilic granulomatosis with polyangitis (EPGA; churg-strauss syndrome – CSS), and also a localized forms of ill-ness. In our research, we studied clinical and serological parameters in patients, in order to find out which of them would be the best predictor of renal outcome in ANCA-associated vasculitis. Methods. Data from 42 patients with diagnose of MPA (9), WG (17), EPGA (0), CSS (0), and al-so idiopathic rapidly progressive glomerulonephritis (ROEB) without immune deposits (renal-limited vasculitis – 16) were analyzed. Cockroft formula was used for calculating the glomerular filtration in the moment of presenting the illness, and also after five year follow-up period. Other factors that were analyzed are: gender, age, type of ANCA antibodies, type of infections, stage of chronic kidney dis-ease, need for heamodialysis and mortality. Results. Of a total of 42 patients, 17 (40.48%) were male. The average age of the patients at the time of diagnosis was 57.8 (± 10.44) years. Seventeen patients (40.48%) had a diagnosis of WG, 9 (21.43%) MPA, and 16 (38.09%) iRPGN. The presence of positive anti-proteinase (anti-PR3) antibodies was confirmed i n 1 8 patients, a nd a nti-MPO antibodies in 17 patients. Three patients had both subtypes of ANCA antibodies (anti-PR3 and anti-MPO). Initially, 12 patients required heamodialysis treatment. Twenty nine patients had a complete and 13 patients had partial remission. Out of the total number of patients, 8 patients (19.04%) developed the terminal renal failure stage, and ended up on a chronic dialysis program. During a five-year follow-up period, 12 patients (28.57%) resulted in death. The age of the patient proved to be statistically significant predictor of glomerular filtration rate (GFR) at the moment of presentation of the disease (p = 0.011). GFR t = 0 was statistically significant (p = 0.000) for the evaluation of kidney function outcomes in ANCA-associated glomerulonephritis. Conclusion. Kidney function in the moment of illness presentation, determined by GFR t = 0, is the most important significant factor for predicting renal outcome in ANCA-associated vasculitis, and also the mortality in these patients.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900135L.pdfglomerulonephritisantibodies, antineutrophil cytoplasmicglomerular filtration ratemortality
spellingShingle Ljubičić Bojana
Azaševac Tijana
Popović Milica
Živković Siniša
Božić Dušan
Ćelić Dejan
Predictors of renal outcome in ANCA-assosiated glomerulonephritis
Vojnosanitetski Pregled
glomerulonephritis
antibodies, antineutrophil cytoplasmic
glomerular filtration rate
mortality
title Predictors of renal outcome in ANCA-assosiated glomerulonephritis
title_full Predictors of renal outcome in ANCA-assosiated glomerulonephritis
title_fullStr Predictors of renal outcome in ANCA-assosiated glomerulonephritis
title_full_unstemmed Predictors of renal outcome in ANCA-assosiated glomerulonephritis
title_short Predictors of renal outcome in ANCA-assosiated glomerulonephritis
title_sort predictors of renal outcome in anca assosiated glomerulonephritis
topic glomerulonephritis
antibodies, antineutrophil cytoplasmic
glomerular filtration rate
mortality
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900135L.pdf
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