title: Long-term Prognosis of Anti-Neutrophil Cytoplasmic Antibody-Negative Renal Vasculitis: Cohort Study in Korea.
abstract: Few studies have reported on the long-term prognosis of anti-neutrophil cytoplasmic antibody (ANCA)-negative renal vasculitis. Between April 2003 and December 2013, 48 patients were diagnosed with renal vasculitis. Their ANCA status was tested using indirect immunofluorescence and enzyme-linked immunosorbent assays. During a median (interquartile range) follow-up duration of 933.5 (257.5-2,079.0) days, 41.7% of patients progressed to end stage renal disease (ESRD) and 43.8% died from any cause. Of 48 patients, 6 and 42 were ANCA-negative and positive, respectively. The rate of ESRD within 3 months was higher in ANCA-negative patients than in ANCA-positive patients (P = 0.038). In Kaplan-Meier survival analysis, ANCA-negative patients showed shorter renal survival than did ANCA-positive patients (log-rank P = 0.033). In univariate Cox-proportional hazard regression analysis, ANCA-negative patients showed increased risk of ESRD, with a hazard ratio 3.190 (95% confidence interval, 1.028-9.895, P = 0.045). However, the effect of ANCA status on renal survival was not statistically significant in multivariate analysis. Finally, ANCA status did not significantly affect patient survival. In conclusion, long-term patient and renal survival of ANCA-negative renal vasculitis patients did not differ from those of ANCA-positive renal vasculitis patients. Therefore, different treatment strategy depending on ANCA status might be unnecessary.
authors.affiliation: Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sung Woo
authors.identifier: 0000-0002-4419-3938
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea .
authors.forename: Mi-Yeon
authors.initials: MY
authors.lastname: Yu
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea .
authors.forename: Seon Ha
authors.initials: SH
authors.lastname: Baek
authors.affiliation: Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Shin-Young
authors.initials: SY
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea .
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Na
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Chae
authors.affiliation: Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea.; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ho Jun
authors.identifier: 0000-0003-1185-2631
authors.initials: HJ
authors.lastname: Chin
mesh_terms: D000367:Age Factors; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000175:diagnosis* / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014657:Vasculitis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic
keywords: Anti-Neutrophil Cytoplasmic Antibody (ANCA); Cohort Studies; Kidney Failure, Chronic; Koreans; Mortality; Prognosis; Proteinuria; Sex; Survival; Vasculitis