Clinicopathological characteristics and predictors of poor outcome in anti-glomerular basement membrane disease – a fifteen year single center experience

Zahir, Zafirah; Wani, Asif Sadiq; Prasad, Narayan; Jain, Manoj

doi:10.1080/0886022x.2020.1854301

Cited by 16 publications

(22 citation statements)

References 25 publications

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“…Renal brosis is closely related to patient prognosis. As renal brosis progresses, functional nephrons gradually decrease, and it eventually progresses to end-stage renal disease (ESRD) [3,4]. Due to a lack of reliable, easy renal brosis assessment methods, it is di cult to precisely determine its prevalence.…”

Section: Introductionmentioning

confidence: 99%

Value of [68Ga]Ga-FAPI-04 imaging in the diagnosis of renal fibrosis

Zhou

Yang

Liu

et al. 2021

Eur J Nucl Med Mol Imaging

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Renal brosis is a pathological state in the progression of chronic kidney disease. Early detection and treatment are vital to prolong the survival of patients. Renal puncture examination represents the gold standard examination method for renal brosis, but it has several limitations. This study aims to evaluate the diagnostic performance of a novel PET radiotracer, [ 68 Ga]Ga-broblast activation protein inhibitor (FAPI)-04, which speci cally images broblast activation protein (FAP) expression for renal brosis. MethodsAll patients underwent renal puncture before receiving [ 68 Ga]Ga-FAPI-04 PET/CT imaging. They then underwent [ 68 Ga]Ga-FAPI-04 PET/CT and immunochemistry examinations, and the data obtained were analyzed. ResultsThe [ 68 Ga]Ga-FAPI-04 PET/CT examination results showed that almost all patients (12/13) exhibited increased radiotracer uptake. The maximum standardized uptake value (SUVmax) in patients with mild, moderate, and severe brosis was 3.92±1.50, 5.98±1.6, and 7.67±2.23, respectively. ConclusionCompared with renal puncture examination, non-invasive imaging of FAP expression through [ 68 Ga]Ga-FAPI-04 PET/CT can quickly show the patient's bilateral kidney condition with high sensitivity. This can facilitate the evaluation of the patient's disease progression, diagnosis, and the development of a treatment plan.

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Section: Introductionmentioning

confidence: 99%

Value of [68Ga]Ga-FAPI-04 imaging in the diagnosis of renal fibrosis

Zhou

Yang

Liu

et al. 2021

Eur J Nucl Med Mol Imaging

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“…found that renal outcome was significantly poorer in patients with older age at diagnosis, female gender, and high level of serum creatinine at presentation [ 15 ]. In a 15-year retrospective study of 48 patients with biopsy-proven renal involvement of anti-GBM disease, oliguria, high serum creatinine, severe glomerulosclerosis, and severe tubular atrophy and interstitial fibrosis were proved to be linked with poor renal survival [ 24 ]. In another Chinese study with 221 patients, after analyzing data from 221 consecutive patients, Cui et al.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and outcome predictors of anti-glomerular basement membrane glomerulonephritis

Liu

Yang

et al. 2022

Renal Failure

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Objective To explore the clinicopathological features of anti-glomerular basement membrane (anti-GBM) glomerulonephritis (anti-GBM-GN) and the prognostic values of clinical and laboratory indicators at diagnosis on renal and patient survival. Methods A total of 76 patients (34 males and 42 females) with anti-GBM-GN who were hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2010 and June 2021 were included in this study. The baseline clinical features, histopathological data from renal biopsies, and predictors of renal and patient survival were retrospectively analyzed. Results Among the 76 patients, the median serum creatinine at diagnosis was 618.0 (350.98, 888.25) μmol/L and the median estimated glomerular filtration rate (eGFR) was 6.62 (4.39, 14.41) mL/min. Of these 76 patients, 55 (72.4%) received initial kidney replacement therapy (KRT) and 39 (51.3%) received plasma exchange or double-filtered plasmapheresis (DFPP). During a median follow-up duration of 28.5 (6.0, 71.8) months, 53 (69.7%) patients progressed to kidney failure with replacement therapy (KFRT) and received maintenance dialysis. Initial KRT (HR = 3.48, 95% CI = 1.22–9.97, p = 0.020) was a significant risk factor for renal survival. During the follow-up, 49 (64.5%) of 76 patients survived. Age (≥60 years, HR = 4.13, 95% CI = 1.65–10.38, p = 0.003) and initial KRT (HR = 2.87, 95% CI = 1.01–8.14, p = 0.047) were predictive of patient survival. Conclusions Among patients with anti-GBM-GN, initial KRT at presentation was predictive of KFRT while older age and initial KRT were associated with higher all-cause mortality.

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“…[ 3 ] Anti-GBM disease is rare, with an estimated incidence of 1 to 2 cases per million population per annum. [ 6 , 7 ] The correlation between anti-GBM disease and ANCA-associated vasculitis has been well documented in many studies, and 21% to 47% of patients with anti-GBM disease are identified with coexisting ANCA-associated vasculitis. [ 4 ] However, concomitant anti-GBM disease with immune complex-mediated glomerulonephritis is rarely reported, among which membranous nephropathy is relatively common, while IgA nephropathy is even rarer.…”

Section: Discussionmentioning

confidence: 99%

Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report

Sensen

Jingda

et al. 2022

Medicine

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Rationale: The causal relationship between anti-glomerular basement membrane (anti-GBM) disease and immunoglobulin A (IgA) nephropathy is still unclear and cases of concurrent anti-GBM disease and IgA nephropathy are very rare, especially with a good prognosis and long-term follow-up. Here, we report a case of concurrent anti-GBM disease and IgA nephropathy. By using corticosteroids and cyclophosphamide in combination with plasmapheresis, the patient achieved a very good prognosis with complete normalization of renal function and complete disappearance of hematuria and proteinuria at the subsequent follow-up. To our knowledge, no previous case with such a long follow-up and such a good prognosis have been reported. Patient concerns: This case report describes a 26-year-old Chinese woman who presented with fever as the initial symptom, followed by dysmorphic hematuria, overt proteinuria and rapidly worsening renal function. Before admission, the patient received symptomatic supportive treatment such as intravenous albumin infusion, improvement of circulation, but the symptoms were not significantly improved. Diagnosis: Per the results of kidney biopsy, the patient was diagnosed with crescentic glomerulonephritis and anti-GBM disease with IgA nephropathy. Interventions: The key to obtain a good prognosis was the early application of corticosteroids and cyclophosphamide in combination with plasmapheresis to make the anti-GBM antibody turn negative quickly. Outcomes: After 2 weeks of therapy, the patients’ anti-GBM antibody turned negative and serum creatinine improved to a normal range. After 10 months, the patient’s proteinuria level reached complete remission. After 12 months, the patient’s hematuria had disappeared completely. Lessons: This case provides experience in the treatment of concurrent anti-GBM disease and IgA nephropathy and highlights the importance of early application of plasmapheresis and immunosuppressive therapy to obtain a good prognosis.

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Clinicopathological characteristics and predictors of poor outcome in anti-glomerular basement membrane disease – a fifteen year single center experience

Cited by 16 publications

References 25 publications

Value of [68Ga]Ga-FAPI-04 imaging in the diagnosis of renal fibrosis

Value of [68Ga]Ga-FAPI-04 imaging in the diagnosis of renal fibrosis

Clinicopathological characteristics and outcome predictors of anti-glomerular basement membrane glomerulonephritis

Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report

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