PMID- 25016608
OWN - NLM
STAT- MEDLINE
DCOM- 20151201
LR  - 20220408
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 30
IP  - 7
DP  - 2015 Jul
TI  - Long-term outcome of anti-neutrophil cytoplasm antibody-associated 
      glomerulonephritis: evaluation of the international histological classification 
      and other prognostic factors.
PG  - 1185-92
LID - 10.1093/ndt/gfu237 [doi]
AB  - BACKGROUND: Anti-neutrophil cytoplasm antibody (ANCA) associated vasculitis with 
      renal involvement requires treatment with potentially toxic drugs to reduce 
      morbidity and mortality, and there is a major challenge to determine clinical and 
      histological features predictive of renal prognosis. The aim of our study was to 
      evaluate the use of the 2010 international histological classification for 
      ANCA-associated glomerulonephritis (AAGN) as a predictor of renal outcome when 
      used in conjunction with other prognostic factors. METHODS: One hundred and four 
      patients with AAGN treated at our centre were included: 23 were classified as 
      focal, 26 as crescentic, 48 as mixed and 7 as sclerotic. Renal outcomes were 
      based on estimated glomerular filtration rate (eGFR) at 1 and 5 years, and on 
      renal survival. RESULTS: By univariate analysis, patients in the focal class had 
      the best renal outcome, those in the sclerotic class the worst outcome, and those 
      in the mixed and crescentic classes had intermediate renal survival. There was no 
      significant difference in outcome between the mixed and crescentic classes. In 
      multivariate models, histological class did not improve model fit or associate 
      with renal outcome after adjusting for established prognostic factors. Lower 
      percentage of normal glomeruli, greater degree of tubular atrophy (TA), MPO-ANCA 
      positivity, increasing age and lower starting eGFR, all correlated with poorer 
      renal outcomes. CONCLUSIONS: We conclude that, in our cohort of patients, the 
      international histological classification is predictive of renal outcome in AAGN, 
      but did not appear to be additionally informative over other established 
      prognostic factors in multivariate analysis. However, it may be of value to 
      combine the current histological classification with other established 
      parameters, such as TA and percentage normal glomeruli.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. 
      All rights reserved.
FAU - Tanna, Anisha
AU  - Tanna A
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Guarino, Laura
AU  - Guarino L
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Tam, Frederick W K
AU  - Tam FW
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Rodriquez-Cubillo, Beatriz
AU  - Rodriquez-Cubillo B
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Levy, Jeremy B
AU  - Levy JB
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Cairns, Tom D
AU  - Cairns TD
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Griffith, Megan
AU  - Griffith M
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Tarzi, Ruth M
AU  - Tarzi RM
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Caplin, Benjamin
AU  - Caplin B
AD  - UCL Centre for Nephrology, Royal Free Hospital, London, UK.
FAU - Salama, Alan D
AU  - Salama AD
AD  - UCL Centre for Nephrology, Royal Free Hospital, London, UK.
FAU - Cook, Terence
AU  - Cook T
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK.
FAU - Pusey, Charles D
AU  - Pusey CD
AD  - Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK 
      c.pusey@imperial.ac.uk.
LA  - eng
GR  - 18235/ARC_/Arthritis Research UK/United Kingdom
GR  - 18235/VAC_/Versus Arthritis/United Kingdom
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140712
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Antineutrophil Cytoplasmic/blood/*classification
MH  - Female
MH  - Follow-Up Studies
MH  - Glomerular Filtration Rate
MH  - Glomerulonephritis/blood/classification/*diagnosis/*mortality
MH  - Humans
MH  - International Agencies
MH  - Kidney/*pathology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - ANCA
OT  - clinical outcome
OT  - glomerulonephritis
OT  - renal pathology
OT  - vasculitis
EDAT- 2014/07/14 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/07/14 06:00
PHST- 2013/11/07 00:00 [received]
PHST- 2014/06/10 00:00 [accepted]
PHST- 2014/07/14 06:00 [entrez]
PHST- 2014/07/14 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - gfu237 [pii]
AID - 10.1093/ndt/gfu237 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2015 Jul;30(7):1185-92. doi: 10.1093/ndt/gfu237. Epub 
      2014 Jul 12.