Modified histopathological classification with age-related glomerulosclerosis for predicting kidney survival in ANCA-associated glomerulonephritis


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Aydin M. F. , YILDIZ A., ORUÇ A., AYTAÇ VURUŞKAN B., Akgur S., Ayar Y., ...More

INTERNATIONAL UROLOGY AND NEPHROLOGY, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1007/s11255-022-03371-6
  • Journal Name: INTERNATIONAL UROLOGY AND NEPHROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Gender Studies Database, MEDLINE
  • Keywords: ANCA, ANCA-associated vasculitis, Anti-neutrophil cytoplasmic antibodies, Age-related glomerulosclerosis, Histopathological classification, Renal pathology, ANTIBODY-ASSOCIATED GLOMERULONEPHRITIS, HISTOLOGICAL CLASSIFICATION, NEPHROSCLEROSIS, VALIDATION, DISEASE, BIOPSY
  • Bursa Uludag University Affiliated: Yes

Abstract

Background The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden's ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis. Methods Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyses were compared according to classical and modified ANCA-GN histopathological classifications. Multivariate Cox regression analysis for the factors affecting renal survival was performed. Results In Berden's ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, eight of the nine patients previously classified in the sclerotic group were classified in the mixed and one in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were significant independent factors. Conclusion Modification of Berden's ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.