|Re-evaluation of the histopathologic classification of ANCA-associated glomerulonephritis: a study of 121 patients in a single center|
|Chang, Dong-yuan1,2,3; Wu, Li-hua1,2,3; Liu, Gang1,2,3; Chen, Min1,2,3; Kallenberg, Cees G. M.4; Zhao, Ming-Hui1,2,3|
|关键词||ANCA-associated glomerulonephritis end-stage renal disease renal histology|
|刊名||NEPHROLOGY DIALYSIS TRANSPLANTATION|
|WOS标题词||Science & Technology|
|类目[WOS]||Transplantation ; Urology & Nephrology|
|研究领域[WOS]||Transplantation ; Urology & Nephrology|
|关键词[WOS]||SMALL-VESSEL VASCULITIS ; CHINESE PATIENTS ; PATHOLOGICAL CHARACTERISTICS ; MICROSCOPIC POLYANGIITIS ; WEGENERS-GRANULOMATOSIS ; RENAL HISTOLOGY ; AUTOANTIBODIES ; DETERMINANTS ; DISEASE ; RELAPSE|
Background. The recently published histopathologic classification of antineutrophil cytoplasmic antibody (ANCA)associated glomerulonephritis might greatly aid in the prognostication of patients at the time of diagnosis. This study aims to re-evaluate the new classification for its prognostic capacity in an independent Chinese series.
Methods. One hundred and twenty-one consecutive patients with ANCA-associated glomerulonephritis, diagnosed in our center from 1997 to 2010, were included in this retrospective study. The renal specimens were reviewed according to the proposed histopathologic classification. The predictive value of the classification for renal outcome and renal response to treatment was analyzed.
Results. Thirty-three (27.3%), 24 (19.8%), 53 (43.8%) and 11 (9.1%) patients were classified as focal, mixed, crescentic and sclerotic ANCA-associated glomerulonephritis, respectively. The renal biopsy categories correlated with initial serum creatinine and the renal response to treatment (P < 0.001, P < 0.01, respectively). The probability of progressing to end-stage renal disease (ESRD) increased with ascending categories of focal, mixed, crescentic and sclerotic glomerulonephritis (P < 0.01). The patients with focal, mixed and crescentic ANCA-associated glomerulonephritis were all at decreased risk for developing ESRD compared with the patients with in the sclerotic category (P < 0.05).
Conclusions. The proposed classification system was re-evaluated for the first time in a relatively large and independent series of patients. This system reflects the severity of the initial renal impairment and can predict, at least to some extent, the renal response to treatment. More importantly, it can independently predict renal outcome, in particular development of ESRD.
|项目编号||30725034 ; 30972733|
|资助机构||National Science Fund for Distinguished Young Scholars ; National Natural Science Fund|
|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.Minist Hlth China, Key Lab Renal Dis, Beijing, Peoples R China
4.Univ Groningen, Univ Med Ctr Groningen, Dept Rheumatol & Clin Immunol, NL-9700 AB Groningen, Netherlands
|Chang, Dong-yuan,Wu, Li-hua,Liu, Gang,et al. Re-evaluation of the histopathologic classification of ANCA-associated glomerulonephritis: a study of 121 patients in a single center[J]. NEPHROLOGY DIALYSIS TRANSPLANTATION,2012,27(6):2343-2349.|
|APA||Chang, Dong-yuan,Wu, Li-hua,Liu, Gang,Chen, Min,Kallenberg, Cees G. M.,&Zhao, Ming-Hui.(2012).Re-evaluation of the histopathologic classification of ANCA-associated glomerulonephritis: a study of 121 patients in a single center.NEPHROLOGY DIALYSIS TRANSPLANTATION,27(6),2343-2349.|
|MLA||Chang, Dong-yuan,et al."Re-evaluation of the histopathologic classification of ANCA-associated glomerulonephritis: a study of 121 patients in a single center".NEPHROLOGY DIALYSIS TRANSPLANTATION 27.6(2012):2343-2349.|