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

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 mortal...

Full description

Saved in:
Bibliographic Details
Published in:Seminars in arthritis and rheumatism 2013-04, Vol.42 (5), p.515-521
Main Authors: Li, Zhi-Ying, Gou, Shen-Ju, MD, Chen, Min, MD, PhD, Zhao, Ming-Hui, MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
ANCA-associated vasculitis
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - epidemiology
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - immunology
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - therapy
Antibodies, Antineutrophil Cytoplasmic - analysis
Cause of Death
China - epidemiology
Cohort Studies
Comorbidity
Dialysis
Drug Therapy, Combination
Female
Glomerulonephritis - epidemiology
Glomerulonephritis - immunology
Glomerulonephritis - therapy
Humans
Immunosuppressive Agents - therapeutic use
Kidney Glomerulus - pathology
Male
Methylprednisolone - therapeutic use
Middle Aged
Mortality
Predictors
Renal Dialysis
Renal Insufficiency, Chronic - epidemiology
Renal Insufficiency, Chronic - immunology
Renal Insufficiency, Chronic - therapy
Rheumatology
Treatment Outcome
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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
ISSN:0049-0172
1532-866X
DOI:10.1016/j.semarthrit.2012.09.005