Retrospective analysis of factors predicting end-stage renal failure or death in patients with microscopic polyangiitis with mainly renal involvement

Kawai, Hirohisa; Banno, Shogo; Kikuchi, Shogo; Nishimura, Nahoko; Nobata, Hironobu; Kimura, Yukihiro; Takezawa, Yumiko; Ogawa, Mari; Suzuki, Keisuke; Kitagawa, Wataru; Miura, Naoto; Imai, Hirokazu

doi:10.1007/s10157-013-0926-1

Cited by 10 publications

(10 citation statements)

References 29 publications

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“…In a Japanese study of MPA patients with renal involvement, the survival was 79.5% at 6 months and 71.1% at 12 months [19]. Similarly, in our cohort, the overall survival rate at 6 and 12 months were 83.9% and 78.2%, respectively.…”

Section: Discussionsupporting

confidence: 75%

“…It was reported that mortality in MPA was significantly higher than in GPA and EGPA, mainly because MPA patients developed severe renal failure at the onset of the disease [6, 9]. Wang et al analysed 64 MPA patients with renal involvement showing that the deterioration of renal function is associated with mortality [14], while another report in Japan found that renal function is not associated with overall survival in MPA patients with renal involvement [19]. In this study, a serum creatinine level ≥500 μmol/L at diagnosis was an independent predictive factor for both mortality and ESRD, with hazard ratios of 2.207 and 8.236, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Many clinical indexes have been reported to have prognostic value in AAV patients, such as age [6, 12, 13], haemoglobin level [8], albumin level [14], Birmingham Vasculitis Activity Score (BVAS) [15, 16] and comorbidities [17]. Many studies have shown that AAV patients with worse renal function have a poorer prognosis [11, 13, 15, 18], including patients with MPA [14, 19]. Given that almost all MPA patients develop renal involvement during the disease course [4, 20], the relationship between renal function and prognosis deserves to be studied.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and outcomes in microscopic polyangiitis patients with renal involvement: a study of 124 Chinese patients

Shi

Shen

2019

BMC Nephrol

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Background Microscopic polyangiitis (MPA) is a systemic autoimmune disease, and renal involvement is frequently present in MPA. MPA patients with renal involvement may have a worse prognosis. In this study, we aimed to evaluate the prognostic factors associated with all-cause death and renal survival in MPA patients with renal involvement. Methods A retrospective observational cohort study was performed. One hundred twenty-four patients newly diagnosed with MPA with renal involvement excluding end-stage renal disease (ESRD) who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from January 2012 to July 2017 were included. All the survivors were followed up with until July 2018. The clinical and laboratory data at the time of the initial MPA diagnosis were collected, and the predictive values of the variables for mortality and renal outcome were analysed. Results Among the 124 patients, 52 were men (41.9%) and 72 were women (58.1%), and the age range was from 25 to 85 years (63.9±10.6 years). Seventy-six patients (61.3%) had pulmonary involvement. Multivariate Cox analysis revealed that age≥65 years (HR: 2.437; P =0.021), serum creatinine≥500 μmol/L (HR=2.207; P =0.009) and interstitial lung disease (ILD) (HR=2.366; P =0.013) were associated with mortality. Cox multivariate analysis identified that serum creatinine≥500 μmol/L (HR=8.236; P <0.001) and ILD (HR=2.649; P =0.001) were independent detrimental factors for renal survival, and immunosuppressive treatment was a protective factor for renal survival (HR=0.349; P =0.001). The area under the ROC curve (AUC) of the serum creatinine level at diagnosis was 0.705 for mortality and 0.870 for progression to ESRD or the doubling of serum creatinine. Conclusions Age, serum creatinine level at diagnosis and ILD were independent predictors of mortality in MPA patients with renal involvement. Serum creatinine level at diagnosis, ILD and immunosuppressive treatment were independently related to renal survival.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and outcomes in microscopic polyangiitis patients with renal involvement: a study of 124 Chinese patients

Shi

Shen

2019

BMC Nephrol

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“…112 A serum creatinine level above 4.6 mg/dL at initial MPA diagnosis was shown to be a good predictive factor for development of end stage renal failure, with 92.3% sensitivity and 84.6%specificity. 113 A recent study identified differential expression of genes associated with toll-like receptor signaling in peripheral neutrophils in MPA, however, evaluating the diagnostic potential of these patterns requires further research. 114 …”

Section: Anca Associated Vasculitides (Aav)mentioning

confidence: 99%

Biomarkers in connective tissue diseases

Jog

James

2017

Journal of Allergy and Clinical Immunology

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Autoimmune connective tissue diseases are clinically variable, making biomarkers desirable for assessing future disease risk, supporting early and accurate diagnosis, monitoring disease activity and progression, selecting therapeutics, and assessing treatment response. Because of their correlations with specific clinical characteristics and often with disease progression, autoantibodies and other soluble mediators are considered potential biomarkers. Additional biomarkers may reflect downstream pathological processes or may appear due to ongoing inflammation and damage. Because of overlap between diseases, some biomarkers have limited specificity for a single autoimmune connective tissue disease. This review describes select current biomarkers that aid in diagnosis and treatment of several major systemic autoimmune connective tissue disorders: systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, and ANCA-associated vasculitides. Newly proposed biomarkers that target various stages in disease onset or progression are also discussed. Newer approaches to overcome the diversity observed in these diseases and to facilitate personalized disease monitoring and treatment are also addressed.

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“…Another study also showed that the overall survival rates at 6 and 12 months after a diagnosis of MPA with renal involvement were 79.5% and 71.1%, respectively. Moreover, the severity of renal insufficiency was not related to the survival rate of patients with MPA with renal involvement (15).…”

mentioning

confidence: 94%

Elevated serum levels of immunoglobulin A correlate with the possibility of readmission in patients with microscopic polyangiitis

et al. 2017

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Retrospective analysis of factors predicting end-stage renal failure or death in patients with microscopic polyangiitis with mainly renal involvement

Abstract: Survival rates do not relate to ESRF in MPA patients with mainly renal involvement. Although patients with ESRF required regular hemodialysis, longer survival can be achieved.

Cited by 10 publications

References 29 publications

Clinical characteristics and outcomes in microscopic polyangiitis patients with renal involvement: a study of 124 Chinese patients

Clinical characteristics and outcomes in microscopic polyangiitis patients with renal involvement: a study of 124 Chinese patients

Biomarkers in connective tissue diseases

Elevated serum levels of immunoglobulin A correlate with the possibility of readmission in patients with microscopic polyangiitis

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