PMID- 36856264
OWN - NLM
STAT- MEDLINE
DCOM- 20230926
LR  - 20240224
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Print)
IS  - 2151-464X (Linking)
VI  - 75
IP  - 10
DP  - 2023 Oct
TI  - Longitudinal Patterns of Renal Function in Antineutrophil Cytoplasmic 
      Antibody-Associated Vasculitis.
PG  - 2190-2198
LID - 10.1002/acr.25100 [doi]
AB  - OBJECTIVE: A spectrum of chronic kidney disease (CKD) and end-stage renal disease 
      (ESRD) may occur in antineutrophil cytoplasmic antibody-associated vasculitis 
      (AAV). The longitudinal trajectory of renal function in AAV is poorly understood. 
      METHODS: Patients with >/=2 creatinine measurements, including at baseline 
      (+/-30 days of treatment initiation), were included from the Mass General Brigham 
      AAV Cohort. We calculated estimated glomerular filtration rate (eGFR). We 
      incorporated longitudinal changes in eGFR into a group-based trajectory model to 
      identify patients with similar patterns of change in renal function. The 
      chi-square test and the Kruskal-Wallis test were used to evaluate differences 
      between groups in categorical variables and non-normally distributed continuous 
      variables, respectively. RESULTS: In 255 AAV patients, we identified 4 renal 
      trajectory groups: rapid decline (n = 20), impaired (n = 82), preserved 
      (n = 129), and recovery (n = 24). The rapid decline and impaired groups had 
      greater baseline comorbidity (P = 0.01) and lower prevasculitis eGFR (P = 0.02). 
      Clinically significant CKD (eGFR <60 ml/minute/1.73 m(2) ) persisted over 5 years 
      in >75% of the impaired group, compared to <40% of patients in the preserved 
      group (P < 0.001). ESRD occurred most frequently in the rapid decline (100%), 
      followed by the impaired and preserved groups (7% each). Baseline AAV renal 
      involvement was present prior to 95% of ESRD. However, ESRD etiology varied, with 
      90% of rapid-onset ESRD attributed to vasculitis, versus 17-44% in impaired or 
      preserved groups (P = 0.001). CONCLUSION: We identified 4 longitudinal patterns 
      of renal function after AAV diagnosis. Our findings highlight the burden of CKD 
      in AAV and provide a framework for future research into personalized care in this 
      vulnerable population.
CI  - (c) 2023 American College of Rheumatology.
FAU - Hanberg, Jennifer S
AU  - Hanberg JS
AD  - Massachusetts General Hospital, Boston.
FAU - Cook, Claire
AU  - Cook C
AD  - Massachusetts General Hospital, Boston.
FAU - Fu, Xiaoqing
AU  - Fu X
AD  - Massachusetts General Hospital, Boston.
FAU - Choi, Hyon K
AU  - Choi HK
AUID- ORCID: 0000-0002-2862-0442
AD  - Massachusetts General Hospital and Harvard Medical School, Boston.
FAU - Zhang, Yuqing
AU  - Zhang Y
AUID- ORCID: 0000-0001-7638-0888
AD  - Massachusetts General Hospital and Harvard Medical School, Boston.
FAU - Wallace, Zachary S
AU  - Wallace ZS
AUID- ORCID: 0000-0003-4708-7038
AD  - Massachusetts General Hospital and Harvard Medical School, Boston.
LA  - eng
GR  - K23 AR073334/AR/NIAMS NIH HHS/United States
GR  - R03 AR078938/AR/NIAMS NIH HHS/United States
GR  - R03AR078938/AR/NIAMS NIH HHS/United States
GR  - K23AR073334/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20230309
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
SB  - IM
MH  - Humans
MH  - Antibodies, Antineutrophil Cytoplasmic
MH  - *Kidney Failure, Chronic/diagnosis/epidemiology/etiology
MH  - *Renal Insufficiency, Chronic/diagnosis/epidemiology/etiology
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/complications/diagnosis
MH  - Kidney/physiology
MH  - Retrospective Studies
PMC - PMC10885164
MID - NIHMS1967946
EDAT- 2023/03/02 06:00
MHDA- 2023/09/26 13:43
PMCR- 2024/10/01
CRDT- 2023/03/01 07:53
PHST- 2022/12/19 00:00 [revised]
PHST- 2022/04/01 00:00 [received]
PHST- 2023/02/07 00:00 [accepted]
PHST- 2024/10/01 00:00 [pmc-release]
PHST- 2023/09/26 13:43 [medline]
PHST- 2023/03/02 06:00 [pubmed]
PHST- 2023/03/01 07:53 [entrez]
AID - 10.1002/acr.25100 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2023 Oct;75(10):2190-2198. doi: 10.1002/acr.25100. 
      Epub 2023 Mar 9.