Anaemia is an essential complication of ANCA-associated renal vasculitis: a single center cohort study

Kawamura, Tetsuya; Usui, Joichi; Kaneko, Shuzo; Tsunoda, Ryoya; Imai, Eri; Kai, Hirayasu; Morito, Naoki; Saito, Chie; Nagata, Michio; Yamagata, Kunihiro

doi:10.1186/s12882-017-0754-8

Cited by 23 publications

(21 citation statements)

References 34 publications

(45 reference statements)

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“…We found that our study and most previous studies had similar conclusions. As a previously reported predictor ( 8 , 10 ), hemoglobin level was also identified in the present study as an important factor influencing renal survival. Different from some previous studies, the results of the present study confirmed that the urine red blood cell count was also predictive of renal survival.…”

Section: Discussionsupporting

confidence: 81%

Outcome Predictors of Biopsy-Proven Myeloperoxidase-Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis

Yang

et al. 2021

Front. Immunol.

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ObjectiveTo determine the prognostic values of histopathologic classification of myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis and other clinical and laboratory features at the time of presentation on renal and patient survival associated with myeloperoxidase-ANCA-associated glomerulonephritis (MPO-ANCA-GN).MethodsA total of 112 patients diagnosed with MPO-ANCA-GN from October 2005 to December 2018 were enrolled. The baseline clinical characteristics, renal histopathological data, and risk factors predictive of renal and patient survival were retrospectively analyzed.ResultsAll 112 patients underwent renal biopsy. Disease in 32 patients was classified as focal, 26 as mixed, 29 as crescentic, and 25 as sclerotic. Over a median follow-up period of 41.5 months, there were 44 patients dialysis-dependent. The renal survival rate was significantly higher in the focal group than the other groups (p < 0.001) and significantly lower in the sclerotic group (p < 0.05). In addition, disease histopathologically classified as sclerotic (p = 0.044), high serum creatinine level (≥320 μmol/L, p < 0.001), low albumin (<30 g/L, p = 0.024) and hemoglobin level (<90 g/L, p = 0.044) were associated with a greater risk of ESRD. After follow-up, 70 (62.5%) of 112 patients survived. Old age (≥60 years, p = 0.018) and low serum albumin (<30 g/L, p = 0.006) was significant risk factor for patient survival.ConclusionAmong patients with MPO-ANCA-GN, those with poor renal function, disease histopathologically classified as sclerotic, and lower albumin and hemoglobin levels were risk factors for ESRD, while older age and low serum albumin level were associated with a greater risk for all-cause mortality.

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Section: Discussionsupporting

confidence: 81%

Outcome Predictors of Biopsy-Proven Myeloperoxidase-Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis

Yang

et al. 2021

Front. Immunol.

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“…Finally, patients with matching IIF and ELISA serologies (who were more likely to receive the diagnosis of AAV) presented with lower hemoglobin levels, higher levels inflammatory markers, and higher RF levels compared to the discrepancy group. A study conducted on a small Japanese Cohort of 45 patients found that all subjects with AAV exhibited anemia which was significantly associated with the degree of renal dysfunction and life prognosis [18]. Similar results were reported by a larger international multicentric study conducted by the European Vasculitis study group, where lower hemoglobin, higher white cell count and a higher CRP to albumin ratio were found to be independent predictors of mortality for patients with AAV [19].…”

Section: Discussionsupporting

confidence: 70%

Clinical implications of ANCA positivity in a hospital setting: a tertiary center experience

et al. 2020

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ANCA testing plays an established critical role in the diagnosis of ANCA Associated vasculitis (AAV). The spectrum of diseases associated with positive ANCA has recently broadened, thus calling into question the diagnostic implications of ANCA positivity in a hospital setting. We retrospectively studied all adult patients who had a positive ANCA test (by Indirect Immunofluorescence (IIF), ELISA or both) performed over the span of 19 years. Subjects were then divided into discordant (positive on one assay) and concordant ANCA (positive on both assays) groups based on their ANCA positivity status. The two groups were then compared with regards to their demographic, clinical and laboratory characteristics, the indication for ANCA testing in both groups and their final diagnoses. Of the 9189 ANCA tests ordered during the 19-year span of the study, 389 (4.2%) were positive. Two hundred and forty subjects met the exclusion criteria (patients aged less than 18 years or the lack of clinical and laboratory data in the medical file) thus resulting in a final cohort of 149 subjects. Of them, 122 subjects had discrepant ANCA results and 27 had matching ANCA results. Most cases in the discrepancy group were IIF positive and ELISA negative (86.8%). The diagnosis of AAV was highly unlikely in cases with discrepant IIF and ELISA serologies compared to cases with matching IIF and ELISA serologies (4.1% versus 44.4%, p value < 0.001). The diagnosis of AAV in unlikely in subjects with discrepancies between IIF and ELISA, particularly with only positive IIF.

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“…First, lymphocyte count may also be affected by general health and stress or various autoimmune diseases and we previously proved the lower number of lymphocyte in severe AAV compared with non‐severe AAV . Second, the reduced hemoglobin was reported to be one of systemic complication of AAV . Third, serum creatinine level is already included in BVAS as one item, and thus, it is naturally accepted that the serum level of creatinine might be correlated with BVAS well …”

Section: Discussionmentioning

confidence: 94%

Multivariable index for assessing the activity and predicting all‐cause mortality in antineutrophil cytoplasmic antibody‐associated vasculitis

Kim

Choi

Kim

et al. 2019

Clinical Laboratory Analysis

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Background: So far, there has been no tool to estimate activity at diagnosis and predict all-cause mortality in patients with ANCA-associated vasculitis (AAV). Hence, we determined the initial predictors of them in patients with AAV. Methods:We retrospectively reviewed the medical records of 182 patients with AAV. Severe AAV was defined as Birmingham Vasculitis Activity Score (BVAS) ≥ 16.The cutoffs were extrapolated by the receiver operator characteristic (ROC) curve.The odds ratio (OR) and the relative risk (RR) were assessed using the multivariable logistic regression analysis and the chi-square test, respectively. Results:In the comparison analysis, patients with severe AAV exhibited the higher neutrophil and platelet counts, creatinine, erythrocyte sedimentation rate and C-reactive protein, and the lower lymphocyte count, hemoglobin, and serum albumin than those without. In the multivariable logistic regression analysis, creatinine ≥ 0.9 mg/dL (OR 2.264), lymphocyte count ≤ 1430.0/mm 3 (OR 1.856), and hemoglobin ≤ 10.8 g/ dL (OR 2.085) were associated with severe AAV. We developed a new equation of a multivariable index for AAV (MVIA) = 0.6 × (Lymphocyte count ≤ 1430.0/mm 3 ) + 0. 7 × (Hemoglobin ≤ 10.8 g/dL) + 0.8 × (Creatinine ≥ 0.9 mg/dL). The optimal cutoff of MVIA for severe AAV was set as 1.35. Severe AAV was identified more frequently in patients with MVIA at diagnosis ≥1.35 than those without (RR 4.432). Patients with MVIA at diagnosis ≥1.35 exhibited the lower cumulative patient survival rate than those without. Conclusion:Multivariable index for AAV could assess the cross-sectional activity and predict all-cause mortality in patients with AAV.

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Anaemia is an essential complication of ANCA-associated renal vasculitis: a single center cohort study

Cited by 23 publications

References 34 publications

Outcome Predictors of Biopsy-Proven Myeloperoxidase-Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis

Outcome Predictors of Biopsy-Proven Myeloperoxidase-Anti-Neutrophil Cytoplasmic Antibody-Associated Glomerulonephritis

Clinical implications of ANCA positivity in a hospital setting: a tertiary center experience

Multivariable index for assessing the activity and predicting all‐cause mortality in antineutrophil cytoplasmic antibody‐associated vasculitis

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