PMID- 37853276 OWN - NLM STAT- Publisher LR - 20231018 IS - 1867-0687 (Electronic) DP - 2023 Oct 19 TI - Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis: a nationwide retrospective study in China. LID - 10.1007/s12519-023-00753-3 [doi] AB - BACKGROUND: Pediatric antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a life-threatening systemic vasculitis featured by liability to renal involvement. However, there are few studies on the risk factors and predictive models for renal outcomes of AAV in children. METHODS: Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively. The risk factors and predictive model of end-stage renal disease (ESRD) in AAV were explored. RESULTS: Renal involvement was the most typical manifestation (95.5%), and the crescent was the predominant pathological lesion (84.9%). The estimated glomerular filtration rate (eGFR) was evaluated in 114 patients, of whom 59.6% developed ESRD, and the median time to ESRD was 3.20 months. The eGFR [P = 0.006, odds ratio (OR) = 0.955, 95% confidence interval (CI) = 0.924-0.987] and the percentages of global glomerulosclerosis (pGGS; P = 0.018, OR = 1.060, 95% CI = 1.010-1.112) were independent risk factors for ESRD of renal biopsy. Based on the pGGS and eGFR at renal biopsy, we developed three risk grades of ESRD and one predictive model. The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades (P < 0.001). Compared with serum creatinine at baseline, the predictive model had higher accuracy (0.86 versus 0.58, P < 0.001) and a lower coefficient of variation (0.07 versus 0.92) in external validation. CONCLUSIONS: Renal involvement is the most common manifestation of pediatric AAV in China, of which more than half deteriorates into ESRD. The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children. Supplementary file 2 (MP4 18937 KB). CI - (c) 2023. The Author(s). FAU - Tan, Li-Wen AU - Tan LW AD - Department of Nephrology, Children's Hospital of Chongqing Medical University, Zhongshan 2nd Rd.136, Chongqing, 400014, China. AD - Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China. AD - Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China. FAU - Wan, Jun-Li AU - Wan JL AD - Department of Nephrology, Children's Hospital of Chongqing Medical University, Zhongshan 2nd Rd.136, Chongqing, 400014, China. AD - Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China. AD - Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China. FAU - Zhu, Chun-Hua AU - Zhu CH AD - Department of Nephrology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China. FAU - Xu, Hong AU - Xu H AD - Department of Nephrology, Children's Hospital of Fudan University, National Paediatric Medical Center of China, Shanghai, China. FAU - Xia, Zheng-Kun AU - Xia ZK AD - Department of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, China. AD - Department of Pediatrics, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China. AD - Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. FAU - Chen, Li-Zhi AU - Chen LZ AD - Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. FAU - Wu, Xiao-Chuan AU - Wu XC AD - Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Wang, Fang AU - Wang F AD - Department of Pediatrics, Peking University First Hospital, Beijing, China. FAU - Liu, Xiao-Rong AU - Liu XR AD - Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. AD - National Center for Children's Health, Beijing, China. FAU - Zhao, Cheng-Guang AU - Zhao CG AD - Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China. FAU - Li, Xiao-Zhong AU - Li XZ AD - Department of Nephrology and Immunology, Children's Hospital of Soochow University, Suzhou, China. FAU - Mao, Jian-Hua AU - Mao JH AD - Department of Nephrology, Children Hospital, Zhejiang University School of Medicine, Hangzhou, China. FAU - Wang, Xiao-Wen AU - Wang XW AD - Department of Nephrology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China. FAU - Huang, Wen-Yan AU - Huang WY AD - Department of Nephrology and Rheumatology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China. FAU - Li, Yu-Hong AU - Li YH AD - Pediatric Nephrology Department, Guiyang Maternal & Child Health Care Hospital, Guiyang, China. FAU - Zhang, Jian-Jiang AU - Zhang JJ AD - Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. FAU - Feng, Shi-Pin AU - Feng SP AD - Department of Nephrology, Chengdu Women and Children Central Hospital, Chengdu, 610041, China. FAU - Yang, Jun AU - Yang J AD - Department of Rheumatology and Immunology, Shenzhen Children's Hospital, Shenzhen, China. FAU - Liu, Jiao-Jiao AU - Liu JJ AD - Department of Nephrology, Children's Hospital of Fudan University, National Paediatric Medical Center of China, Shanghai, China. FAU - Gao, Chun-Lin AU - Gao CL AD - Department of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, China. AD - Department of Pediatrics, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China. AD - Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. FAU - Rong, Li-Ping AU - Rong LP AD - Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. FAU - Shuai, Lan-Jun AU - Shuai LJ AD - Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China. FAU - Xu, Ke AU - Xu K AD - Department of Pediatrics, Peking University First Hospital, Beijing, China. FAU - Zhang, He-Jia AU - Zhang HJ AD - Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. AD - National Center for Children's Health, Beijing, China. FAU - Li, Qiu AU - Li Q AD - Department of Nephrology, Children's Hospital of Chongqing Medical University, Zhongshan 2nd Rd.136, Chongqing, 400014, China. AD - Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China. AD - Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China. FAU - Zhang, Ai-Hua AU - Zhang AH AD - Department of Nephrology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China. zhaihua@njmu.edu.cn. FAU - Wang, Mo AU - Wang M AUID- ORCID: 0000-0003-1673-3631 AD - Department of Nephrology, Children's Hospital of Chongqing Medical University, Zhongshan 2nd Rd.136, Chongqing, 400014, China. wangmo_cqmu@163.com. AD - Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China. wangmo_cqmu@163.com. AD - Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China. wangmo_cqmu@163.com. LA - eng GR - 2021YFC2702002/National Key R&D Program of China/ GR - BE2021607/Key Technologies Research and Development Program of Anhui Province/ GR - NCRCCHD-2020-GP-01/Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center/ PT - Journal Article DEP - 20231019 PL - Switzerland TA - World J Pediatr JT - World journal of pediatrics : WJP JID - 101278599 SB - IM OTO - NOTNLM OT - Antineutrophil cytoplasmic antibody OT - End-stage renal disease OT - Glomerulonephritis OT - Pediatric nephrology OT - Vasculitis EDAT- 2023/10/19 00:43 MHDA- 2023/10/19 00:43 CRDT- 2023/10/18 23:43 PHST- 2023/03/03 00:00 [received] PHST- 2023/07/31 00:00 [accepted] PHST- 2023/10/19 00:43 [medline] PHST- 2023/10/19 00:43 [pubmed] PHST- 2023/10/18 23:43 [entrez] AID - 10.1007/s12519-023-00753-3 [pii] AID - 10.1007/s12519-023-00753-3 [doi] PST - aheadofprint SO - World J Pediatr. 2023 Oct 19. doi: 10.1007/s12519-023-00753-3.