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学科主题: 临床医学
题名:
Predictors for Outcomes in Patients with Severe ANCA-associated Glomerulonephritis who were Dialysis-dependent at Presentation: A Study of 89 Cases in a Single Chinese Center
作者: Li, Zhi-Ying1,2,3,4,5; Gou, Shen-Ju1,2,3,4,5; Chen, Min1,2,3,4,5; Zhao, Ming-Hui1,2,3,4,5
关键词: ANCA-associated vasculitis ; Dialysis ; Mortality ; Predictors
刊名: SEMINARS IN ARTHRITIS AND RHEUMATISM
发表日期: 2013-04-01
DOI: 10.1016/j.semarthrit.2012.09.005
卷: 42, 期:5, 页:515-521
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Rheumatology
研究领域[WOS]: Rheumatology
关键词[WOS]: ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES ; ANTIBODY-ASSOCIATED VASCULITIS ; RANDOMIZED-TRIAL ; WEGENERS-GRANULOMATOSIS ; HISTOPATHOLOGIC CLASSIFICATION ; PATHOLOGICAL CHARACTERISTICS ; SYSTEMIC VASCULITIDES ; ORAL CYCLOPHOSPHAMIDE ; RENAL VASCULITIS ; PULSE
英文摘要:

Objective: Anti-neutrophilcytoplasmic autoantibody (ANCA)-associated vasculitis may cause rapid deterioration of renal function, resulting in high prevalence of end-stage renal disease and mortality. The current study investigated factors associated with restoration of renal function and early mortality in patients with severe ANCA-associated glomerulonephritis, i.e. dialysis-dependent at presentation, in a single Chinese cohort.

Methods: Eighty-nine Chinese patients with ANCA-associated glomerulonephritis who were on dialysis at the time of diagnosis were included in this study. All these patients received immunosuppressive therapy plus intravenous methylprednisolone, plasma exchange, or both. The predictive value of the clinical and histological parameters for renal and patient outcome was analyzed.

Result: On the sixth month, 25 (28.1%) patients achieved dialysis independence, 45 (50.6%) patients progressed to end stage renal disease, and 19 (21.3%) patients died. Nine out of the 19 deaths were therapy-related. Factors independently associated with renal function restoration were percentages of normal glomeruli (P < 0.05), extent of tubular atrophy (P < 0.05) and extent of interstitial fibrosis (P < 0.05) in the renal specimens. Age and pulmonary hemorrhage were independently associated with all-cause death (P = 0.003 and P = 0.007, respectively) and therapy-related death (P = 0.037 and P = 0.043, respectively).

Conclusions: Among patients with severe ANCA-associated glomerulonephritis who were dialysis-dependent at presentation, those with a higher percentage of normal glomeruli and less extent of tubular atrophy/interstitial fibrosis have more chance of restoration of renal function. Increased risk for all-cause death and therapy-related death appears to be older age and pulmonary hemorrhage. (C) 2013 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 42:515-521

语种: 英语
所属项目编号: 2012CB517702 ; 2011BA110B04 ; 30972733 ; 81021004
项目资助者: Chinese 973 project ; Ministry of Science and Technology of China ; National Natural Science Fund
WOS记录号: WOS:000318255600007
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/56075
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Dept Med, Div Renal, Beijing 100871, Peoples R China
2.Peking Univ, Inst Nephrol, Beijing 100871, Peoples R China
3.Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China
4.Minist Hlth China, Key Lab Renal Dis, Beijing, Peoples R China
5.Peking Univ, Minist Educ, Key Lab Chron Kidney Dis Prevent & Treatment, Beijing 100871, Peoples R China

Recommended Citation:
Li, Zhi-Ying,Gou, Shen-Ju,Chen, Min,et al. Predictors for Outcomes in Patients with Severe ANCA-associated Glomerulonephritis who were Dialysis-dependent at Presentation: A Study of 89 Cases in a Single Chinese Center[J]. SEMINARS IN ARTHRITIS AND RHEUMATISM,2013,42(5):515-521.
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