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学科主题: 临床医学
题名:
Re-evaluation of the histopathologic classification of ANCA-associated glomerulonephritis: a study of 121 patients in a single center
作者: 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
发表日期: 2012-06-01
DOI: 10.1093/ndt/gfr643
卷: 27, 期:6, 页:2343-2349
收录类别: SCI
文章类型: Article
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
英文摘要:

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.

语种: 英语
所属项目编号: 30725034 ; 30972733
项目资助者: National Science Fund for Distinguished Young Scholars ; National Natural Science Fund
WOS记录号: WOS:000304832100034
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59790
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.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

Recommended Citation:
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.
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