Prognostic Value of Histologic Classification of ANCA-Associated Glomerulonephritis

Abstract

The histopathologic classification is a predictor of renal outcome of moderate quality. Merging the mixed and crescentic classes in the future could simplify the scheme.

The Histopathological Classification of ANCA-associated Glomerulonephritis Comes of Age

“…The lack of a consistent relationship between class and patient survival is consistent with the literature, including the 250 patients in Bjørneklett, et al's study, for whom there was no difference in patient survival across the classes at 1 year 16 . This could be (as explained by the authors) due to the multifactorial characteristic of patient survival in AAV, and the fact that morbidity and mortality cannot be solely attributable to renal involvement.…”

“…These studies have varied in size and, to our knowledge, 7 studies have included over 100 biopsies 9,10,11,12,13,14,15,16 . The first 6 of these studies have been summarized in publications by Rahmattulla, et al 17 and van Daalen, et al 18 .…”

“…The first 6 of these studies have been summarized in publications by Rahmattulla, et al 17 and van Daalen, et al 18 . The largest and most recent was carried out by Bjørneklett, et al 16 in Norway, and included 250 patients with AAV. The study agreed with the general consensus that the classification is a useful predictor of renal outcome, with patients in the focal class experiencing the best and patients in the sclerotic class the worst renal outcomes 16 .…”

“…The largest and most recent was carried out by Bjørneklett, et al 16 in Norway, and included 250 patients with AAV. The study agreed with the general consensus that the classification is a useful predictor of renal outcome, with patients in the focal class experiencing the best and patients in the sclerotic class the worst renal outcomes 16 . There was no significant difference in renal outcome between the mixed and crescentic classes.…”

“…There was no significant difference in renal outcome between the mixed and crescentic classes. Bjørneklett, et al also calculated the prognostic accuracy of the classification system using receiver-operator curve characteristics, and determined it to be of moderate quality 16 .…”