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Prognostic Factors for Survival and Relapse in ANCA-Associated Vasculitis with Renal Involvement: A Clinical Long-Term Follow-Up Study
المؤلفون المشاركون
Poussa, Tuija
Salmela, Anna
Törnroth, Tom
Ekstrand, Agneta
المصدر
International Journal of Nephrology
العدد
المجلد 2018، العدد 2018 (31 ديسمبر/كانون الأول 2018)، ص ص. 1-11، 11ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2018-10-16
دولة النشر
مصر
عدد الصفحات
11
التخصصات الرئيسية
الملخص EN
Aim.
We describe the clinical pattern of ANCA-associated vasculitis (AAV) and assess long-term prognostic factors of patients and renal survival and relapse.
Methods.
Data from 85 patients with renal biopsy-proven AAV at a single center with up to 20-year [median 16.2 years (95% CI 14.9-17.7)] follow-up were retrospectively collected.
Results.
Overall, 55% of the patients had microscopic polyangiitis (MPA) and 45% had granulomatosis with polyangiitis (GPA).
The histopathological classes were focal in 35%, crescentic in 26%, mixed in 20%, and sclerotic glomerulonephritis in 19% of the patients.
As induction treatment, a combination of cyclophosphamide and corticosteroids was given to 82%, while a combination of azathioprine and corticosteroids was maintenance therapy in 79%.
The twenty-year patient survival was 45%.
In a multivariable analysis, age ≥58 years [hazard ratio (HR) 7.64, 95% CI 3.44-16.95] and myeloperoxidase (MPO) ANCA (HR 2.12, 95% CI 1.08-4.17) were associated with shorter patient survival time.
Renal survival was 68% overall: 88% in focal, 71% in crescentic, 56% in mixed, and 37% in sclerotic class (p=0.01).
Female sex (HR 0.26, 95% CI 0.10-0.73) was a predictor of improved renal survival, whereas GFR <30 ml/min and MPO-ANCA were associated with worse renal survival (HR 4.10, 95% CI 1.35-12.49 and HR 3.10, 95% CI 1.21-7.95, respectively).
Relapse-free survival at 20 years was 10%.
MPA was associated with a lower risk for relapse (HR 0.48, 95% CI 0.28–0.82).
Conclusion.
We confirmed the improved patient and renal survival in AAV patients with glomerulonephritis, while relapse remained the primary challenge.
Histopathological classification may be relevant for survival.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Salmela, Anna& Törnroth, Tom& Poussa, Tuija& Ekstrand, Agneta. 2018. Prognostic Factors for Survival and Relapse in ANCA-Associated Vasculitis with Renal Involvement: A Clinical Long-Term Follow-Up Study. International Journal of Nephrology،Vol. 2018, no. 2018, pp.1-11.
https://search.emarefa.net/detail/BIM-1173652
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Salmela, Anna…[et al.]. Prognostic Factors for Survival and Relapse in ANCA-Associated Vasculitis with Renal Involvement: A Clinical Long-Term Follow-Up Study. International Journal of Nephrology No. 2018 (2018), pp.1-11.
https://search.emarefa.net/detail/BIM-1173652
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Salmela, Anna& Törnroth, Tom& Poussa, Tuija& Ekstrand, Agneta. Prognostic Factors for Survival and Relapse in ANCA-Associated Vasculitis with Renal Involvement: A Clinical Long-Term Follow-Up Study. International Journal of Nephrology. 2018. Vol. 2018, no. 2018, pp.1-11.
https://search.emarefa.net/detail/BIM-1173652
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1173652
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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