Health
Identifying predictors of advanced CKD in ANCA-associated vasculitis
Researchers have identified factors that predict the development of progressive chronic kidney disease (CKD). Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis According to recent studies, it is associated with renal impairment.
This study confirmed that elevated serum creatinine levels or decreased estimated glomerular filtration rate (eGFR) at baseline identify patients at high risk for renal injury. We also found that the best predictors of advanced CKD at the end of follow-up were sclerosis class at biopsy and serum creatinine levels at baseline, end of induction, and after 12 months of treatment. .Buenos Aires, Argentina, and colleagues reported rheumatism international.
The authors state that, to their knowledge, their study “is one of the few studies evaluating prognostic factors within the first year of renal disease in ANCA-associated vasculitis.”
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This observational, retrospective study included 60 patients with biopsy-proven ANCA glomerulonephritis with at least 1 year of follow-up. Of these, 46 (76.7%) were female. The patient’s mean age at diagnosis was 67.8 years, and he had a median follow-up of 4.2 years. At the end of follow-up, 12 patients (20%) had her eGFR less than her 30 mL/min/1.73 m.2consistent with advanced CKD.
In univariate analysis, sclerosing class biopsy was significantly associated with a 7.2-fold increase in the odds of advanced CKD at the end of follow-up. “This can be explained by the irreversible nature of these lesions, which are less responsive to treatment and thus restore renal function,” explained Dr. Alle and his colleagues.
According to the researchers, the most accurate predictor of advanced CKD diagnosis was serum creatinine at the end of induction and at 12 months, according to the receiver-operator curve, with areas under the curves of 0.93 and 0.94, respectively. The optimal cut-off value for serum creatinine at the end of run-in was ≥1.60 mg/dL, with sensitivity and specificity of 100% and 75%, respectively. At 12 months, the optimal cut-off value was ≥1.71 mg/dL, with sensitivity and specificity of 90% and 85%, respectively.
The authors conclude that their study “highlights the importance of predictors such as serum creatinine or eGFR obtained after the induction phase of therapy and after 12 months of therapy, highlighting the importance of early therapeutic response.” ing.
reference
Alle G, Scolnik M, Scarlioni V, et al. Prognostic factors associated with advanced chronic kidney disease in a cohort of patients with ANCA vasculitis and renal involvement. Rheumatoid arthritisPublished online January 13, 2023. doi:10.1007/s00296-023-05272-y
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