Clinical course and outcome predictors in pauci-immune ANCA-positive renal-limited vasculitis.
Our aim was to assess the clinical course and outcome of ANCA-positive, pauci-immune renal limited vasculitis, their correlation with laboratory and histopathologic parameters recorded at initial and follow up testing, and to identify the possible outcome predictors. The study included 17 patients with renal biopsy, clinical, serologic and histopathologic parameters meeting the criteria for pauci-immune ANCA-positive glomerulonephritis without extrarenal manifestations of the disease. Creatinine clearance, 24-hour proteinuria and ANCA titer by ELISA method were determined at disease onset, during treatment and at the end of follow up. In 15 patients, the diagnosis was verified by kidney biopsy. Data were processed by Spearman correlation coefficient and Mann-Whitney test, and survival by Kaplan-Meier test. Lower percentage of glomeruli affected with vasculitis, better initial renal function as measured by serum creatinine or creatinine clearance, and lower chronicity on biopsy were identified as favorable indicators of kidney function outcome. Therapy responders had highest initial and lowest final 24-h proteinuria. The highest level of final 24-h proteinuria was recorded in dialysis dependent patients. The cumulative one-year and two-year patient and kidney survival rate was 64% and 50%, and 64% and 38%, respectively.
University Department of Internal Medicine, Osijek University Hospital Center, Osijek, Croatia. vesna.rupcic@optinet.hr
Vesna
V
Rupcić
Marko
M
Jakić
Vinka
V
Rupcić
Vedrana
V
Vizjak
Mirjana
M
Fijacko
D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis* / Q000628:therapy; D002908:Chronic Disease; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D011379:Prognosis; D012074:Remission Induction; D006435:Renal Dialysis
D007166:Immunosuppressive Agents