Development of a Kidney Prognostic Score in a Japanese Cohort of Patients With Antineutrophil Cytoplasmic Autoantibody Vasculitis

Takeda, Rei; Takahashi, Kazuya; Kronbichler, Andreas; Akiyama, Daiichiro; Hanai, Shunichiro; Kobayashi, Yoshiaki; Matsuki, Ayako; Umibe, Takeshi; Ito, Chisaki; Sugimoto, Toyohiko; Sugiyama, Takao; Yoshida, Shun; Nishio, Yasuhide; Nukui, Ikuo; Nakashima, Ayumu; Wakabayashi, Hanae; Asanuma, Katsuhiko; Furuta, Shunsuke; Nakajima, Hiroshi; Nakagomi, Daiki

doi:10.1016/j.ekir.2024.01.007

Cited by 2 publications

(1 citation statement)

References 55 publications

(78 reference statements)

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“…One is an overseas report including both MPO-ANCA and PR3-ANCA [ 11 ]. The other is a Japanese report, which includes MPA, GPA and EGPA, and examines long-term prognosis at 5 years [ 12 ]. They are different perspective from the present study.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment

Owaki,

Tanaka,

Furuhashi

et al. 2024

Clin Exp Nephrol

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Background Kidney and life outcomes remain unsatisfactory in patients with microscopic polyangiitis (MPA). Appropriate treatment intensity must be provided to the appropriate patients. To identify severe cases early, we investigated the factors related to kidney and life outcomes. Methods We included patients diagnosed with MPA based on myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) positivity and kidney histopathology results after kidney biopsies between January 1, 2021, and May 11, 2023, at 10 affiliated centers, including our hospital. Death, maintenance dialysis, and estimated glomerular filtration rate (eGFR) < 15 after 6 months of treatment were defined as poor prognosis groups, and factors associated with these conditions were investigated. Results We included 84 (36 men and 48 women) patients in this study. Median age was 73.8 (interquartile range: 71–81) years. After 6 months of treatment, the proportion of patients in the poor prognosis group was 16.7 %, with a mortality of 7.1 % and a poor kidney prognosis rate of 9.5 %. Area under the receiver operating characteristic curve showed that eGFR at 2 weeks had a comparable prognostic performance equal as eGFR at 4 weeks (area under the curve: 0.875 and 0.896, respectively). After adjustment by various factors, eGFR at 2 weeks was related with prognosis significantly (p = 0.031). Conclusion Kidney function 2 weeks after the start of treatment for MPA can predict prognosis.

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Section: Discussionmentioning

confidence: 99%

Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment

Owaki,

Tanaka,

Furuhashi

et al. 2024

Clin Exp Nephrol

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Performance of clinical and histological prognostic scores for kidney survival in ANCA-associated vasculitis

Sandino-Bermúdez,

Hernández-Andrade,

Hinojosa-Azaola

et al. 2024

Rheumatology

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Objectives Integrating clinical and histological parameters into prognostic scores may enhance the prediction of progression to kidney failure in anti-neutrophil cytoplasm antibodies-associated vasculitis (AAV). This study aimed to evaluate the prognostic performance of histological classifications and scoring systems for kidney survival in AAV. Methods This retrospective cohort study included 101 AAV patients with kidney involvement diagnosed by biopsy and followed for ≥12 months. The main outcome was the time to kidney failure. The prognostic performance of each histological and prognostic score was evaluated using Harrell’s C statistic and Akaike’s Information Criteria. Results Among the 101 patients, 37 progressed to kidney failure over a median follow-up of 75 months (IQR 39–123). The Harrell’s C statistic was 0.702 (0.620–0.784), 0.606 (0.473–0.738), 0.801 (0.736–0.867), 0.782 (0.706–0.858) and 0.817 (0.749–0.885) for the EUVAS/Berden classification, Mayo Clinic Chronicity Score, Percentage of ANCA Crescentic Score (PACS), ANCA renal risk score (ARRS), and the improved ANCA kidney risk score (AKRiS), respectively. The AKRiS best discriminated the risk of kidney failure progression among subgroups. The AKRiS performance decreased with longer follow-up intervals. Adding the peak estimated glomerular filtration rate attained post-therapy improved the AKRiS performance at all follow-up intervals. Kidney relapses precipitated kidney failure in 71% of cases that progressed after the first year of follow-up. Conclusion The novel AKRiS enhances the prediction of kidney failure in AAV with kidney involvement. As the prognostic yield of AKRiS decreases over time, a second calculation of AKRiS, including post-therapy kidney function, may improve its long-term performance.

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Development of a Kidney Prognostic Score in a Japanese Cohort of Patients With Antineutrophil Cytoplasmic Autoantibody Vasculitis

Cited by 2 publications

References 55 publications

Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment

Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment

Performance of clinical and histological prognostic scores for kidney survival in ANCA-associated vasculitis

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