PMID- 27272254
OWN - NLM
STAT- MEDLINE
DCOM- 20170718
LR  - 20181113
IS  - 1573-2584 (Electronic)
IS  - 0301-1623 (Linking)
VI  - 48
IP  - 9
DP  - 2016 Sep
TI  - Impact of renal involvement on survival in ANCA-associated vasculitis.
PG  - 1477-82
LID - 10.1007/s11255-016-1330-z [doi]
AB  - BACKGROUND: Renal involvement is a serious complication of anti-neutrophil 
      cytoplasmic antibody-associated vasculitis (AAV). We describe the pattern of 
      renal involvement and its correlation with outcomes. PATIENTS AND METHODS: 
      Medical records of 92 patients seen in rheumatology clinic and diagnosed as AAV 
      between January 2007 and June 2014 were analysed. Patients were classified as 
      granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), 
      eosinophilic granulomatosis with polyangiitis (EGPA) and undifferentiated AAV. 
      Overall and renal outcomes were analysed. Patients were classified as advanced 
      renal failure (creatinine >5.7 mg/dl or requiring dialysis), deranged RFT not 
      qualifying the above parameters, and normal renal function. RESULTS: Sixty-seven 
      (72.8 %) patients had GPA, 14 (15.2 %) had MPA, 8 (8.7 %) had EGPA, and 3 (3.3 %) 
      had undifferentiated AAV. Renal involvement was seen in 51 (55.4 %) patients 
      (46.3 % of GPA patients, 78.6 % of MPA, 37.5 % of EGPA and 33.3 % of 
      unclassifiable AAV patients). Renal involvement was more common in males 
      (p = 0.008). Patients with renal involvement had higher mean BVAS scores as 
      compared to patients without renal involvement (p < 0.01). Thirteen patients 
      (25.5 %) presented with advanced renal failure (creatinine >5.7 mg/dl or 
      requiring dialysis), 21 (41.2 %) had deranged renal functions but did not require 
      dialysis, and the rest had proteinuria and active sediments with normal serum 
      creatinine. Twenty-four patients (47.1 %) had good renal outcome with normal 
      creatinine, 12 (23.5 %) had persistent renal insufficiency, 12 (23.5 %) died, and 
      one (2 %) remained dialysis dependent. Mean survival and mortality did not differ 
      in patients with and without renal involvement (p = 0.454, p = 0.388). 
      CONCLUSIONS: Renal involvement was more common in males. BVAS was higher in 
      patients with renal involvement. The mean survival and mortality were similar in 
      patients with or without renal involvement.
FAU - Rathi, Manish
AU  - Rathi M
AD  - Department of Nephrology, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Pinto, Benzeeta
AU  - Pinto B
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Dhooria, Aadhaar
AU  - Dhooria A
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Sagar, Vinay
AU  - Sagar V
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Mittal, Tarun
AU  - Mittal T
AD  - Department of Nephrology, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Rajan, Roopa
AU  - Rajan R
AD  - Department of Neurology, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Dhir, Varun
AU  - Dhir V
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Kumar, Susheel
AU  - Kumar S
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Sharma, Kusum
AU  - Sharma K
AD  - Department of Microbiology, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Nada, Ritambhra
AU  - Nada R
AD  - Department of Histopathology, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Singh, Surjit
AU  - Singh S
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Minz, Ranjana Walker
AU  - Minz RW
AD  - Department of Immunopathology, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India.
FAU - Sharma, Aman
AU  - Sharma A
AD  - Department of Internal Medicine, Post Graduate Institute of Medical Education and 
      Research (PGIMER), Chandigarh, 160012, India. amansharma74@yahoo.com.
LA  - eng
PT  - Journal Article
DEP - 20160606
PL  - Netherlands
TA  - Int Urol Nephrol
JT  - International urology and nephrology
JID - 0262521
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications/drug 
      therapy
MH  - Churg-Strauss Syndrome/complications/drug therapy
MH  - Creatinine/blood
MH  - Female
MH  - Follow-Up Studies
MH  - Granulomatosis with Polyangiitis/complications/drug therapy
MH  - Humans
MH  - Male
MH  - Microscopic Polyangiitis/complications/drug therapy
MH  - Middle Aged
MH  - Proteinuria/etiology
MH  - Renal Dialysis
MH  - Renal Insufficiency/*etiology/*physiopathology/therapy
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - ANCA
OT  - EGPA
OT  - GPA
OT  - India
OT  - MPA
OT  - Renal involvement
EDAT- 2016/06/09 06:00
MHDA- 2017/07/19 06:00
CRDT- 2016/06/09 06:00
PHST- 2016/02/09 00:00 [received]
PHST- 2016/05/23 00:00 [accepted]
PHST- 2016/06/09 06:00 [entrez]
PHST- 2016/06/09 06:00 [pubmed]
PHST- 2017/07/19 06:00 [medline]
AID - 10.1007/s11255-016-1330-z [pii]
AID - 10.1007/s11255-016-1330-z [doi]
PST - ppublish
SO  - Int Urol Nephrol. 2016 Sep;48(9):1477-82. doi: 10.1007/s11255-016-1330-z. Epub 
      2016 Jun 6.