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2018 ; 2018
(ä): 5653612
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Prognostic Factors in Anti-Neutrophil Cytoplasmic Antibody-Associated
Glomerulonephritis with Severe Glomerular Sclerosis: A National Registry-Based
Cohort Study
#MMPMID29973979
Bjørneklett R
; Solbakken V
; Bostad L
; Fismen AS
Patholog Res Int
2018[]; 2018
(ä): 5653612
PMID29973979
show ga
BACKGROUND: Classification of patients with anti-neutrophil cytoplasmic
antibody-associated glomerulonephritis (ANCA-GN) into histological classes is
useful for predicting a patient's risk of progression to end-stage renal disease
(ESRD). However, even in the worst prognostic group, the 5-year end-stage renal
disease-free survival rate is as high as 50%. OBJECTIVES: To investigate those
prognostic factors indicative of progression to ESRD in patients with ANCA-GN and
sclerosing histology. METHODS: Patients from the Norwegian Kidney Biopsy Registry
between 1991 and 2012 who had biopsy verified pauci-immune glomerulonephritis,
positive ANCA serology, and sclerosing histology were included. Cases with ESRD
during follow-up were identified via linkage with the Norwegian Renal Registry.
Potential prognostic factors with relevant cut-offs were compared in patients
with and without progression to ESRD during follow-up. RESULTS: Of 23 included
patients, 10 progressed to ESRD. ESRD patients had a lower initial estimated
glomerular filtration rate (eGFR; 21 versus 52?ml/min/1.73?m(2)) and a lower
percentage of normal glomeruli (4% versus 15%). Five-year risks of ESRD with eGFR
>15 versus ?15?ml/min/1.73?m(2) were 77% and 15%, with percentage normal
glomeruli >10% versus ?10%, 83% and 39%. CONCLUSIONS: eGFR and percentage of
normal glomeruli are strong risk factors for ESRD in ANCA-GN with sclerosing
histology.