Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis.
<h4>Introduction</h4>Crescentic glomerulonephritis (CrGN) is a histologic feature of severe glomerular injury, clinically characterized by a rapid decline of renal function when not treated in a timely fashion. Factors associated with CrGN prognosis have not been thoroughly investigated....
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0236051 |
| _version_ | 1818400994587836416 |
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| author | Jeong-Hoon Lim Man-Hoon Han Yong-Jin Kim Yena Jeon Hee-Yeon Jung Ji-Young Choi Jang-Hee Cho Chan-Duck Kim Yong-Lim Kim Hajeong Lee Dong Ki Kim Kyung Chul Moon Sun-Hee Park |
| author_facet | Jeong-Hoon Lim Man-Hoon Han Yong-Jin Kim Yena Jeon Hee-Yeon Jung Ji-Young Choi Jang-Hee Cho Chan-Duck Kim Yong-Lim Kim Hajeong Lee Dong Ki Kim Kyung Chul Moon Sun-Hee Park |
| author_sort | Jeong-Hoon Lim |
| collection | DOAJ |
| description | <h4>Introduction</h4>Crescentic glomerulonephritis (CrGN) is a histologic feature of severe glomerular injury, clinically characterized by a rapid decline of renal function when not treated in a timely fashion. Factors associated with CrGN prognosis have not been thoroughly investigated. This study investigated the prognostic predictors of renal outcomes associated with CrGN, such as the histopathologic classification of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis, arteriosclerosis, and tertiary lymphoid organ (TLO) formation.<h4>Methods</h4>A total of 114 patients diagnosed with CrGN between 2010 and 2018 at two university-based hospitals has been retrospectively analyzed. Relationships between potential predictors and renal outcomes were analyzed using Cox proportional hazards model and linear regression analysis.<h4>Results</h4>The mean age was 61.0 ± 15.3 years, and 49.1% were male. Among them, 92 (80.7%) and 11 (9.6%) patients were positive for ANCA and for anti-glomerular basement membrane antibody, respectively. During the median follow-up of 458.0 days, 55 patients (48.2%) had advanced to end-stage renal disease (ESRD). Cox proportional hazards analysis revealed that patients under the mixed and sclerotic classes had worse renal survival compared to those in the focal class (mixed: hazard ratio [HR], 3.74; 95% confidence interval [CI], 1.18 to 11.82; P = 0.025; sclerotic: HR, 4.84; 95% CI, 1.44 to 16.32; P = 0.011). Severe arteriosclerosis was also associated with poor renal survival (HR, 2.44; 95% CI, 1.04 to 5.77; P = 0.042). TLOs were observed in 41 patients (36.0%). Moreover, TLO formation was also a prognostic factor for ESRD (HR, 1.82; 95% CI, 1.03 to 3.21; P = 0.040). In the multivariate linear regression analysis, age and sclerotic class were independent predictors for the change in estimated glomerular filtration rate during 1 year after biopsy.<h4>Conclusions</h4>Specific histopathologic findings, histopathologic classification, severity of arteriosclerosis, and TLO formation provide helpful information in predicting renal outcomes associated with CrGN. |
| first_indexed | 2024-12-14T07:45:25Z |
| format | Article |
| id | doaj.art-2b05a4a699d34267ac9201e1e3f48fb6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T07:45:25Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-2b05a4a699d34267ac9201e1e3f48fb62022-12-21T23:10:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01157e023605110.1371/journal.pone.0236051Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis.Jeong-Hoon LimMan-Hoon HanYong-Jin KimYena JeonHee-Yeon JungJi-Young ChoiJang-Hee ChoChan-Duck KimYong-Lim KimHajeong LeeDong Ki KimKyung Chul MoonSun-Hee Park<h4>Introduction</h4>Crescentic glomerulonephritis (CrGN) is a histologic feature of severe glomerular injury, clinically characterized by a rapid decline of renal function when not treated in a timely fashion. Factors associated with CrGN prognosis have not been thoroughly investigated. This study investigated the prognostic predictors of renal outcomes associated with CrGN, such as the histopathologic classification of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis, arteriosclerosis, and tertiary lymphoid organ (TLO) formation.<h4>Methods</h4>A total of 114 patients diagnosed with CrGN between 2010 and 2018 at two university-based hospitals has been retrospectively analyzed. Relationships between potential predictors and renal outcomes were analyzed using Cox proportional hazards model and linear regression analysis.<h4>Results</h4>The mean age was 61.0 ± 15.3 years, and 49.1% were male. Among them, 92 (80.7%) and 11 (9.6%) patients were positive for ANCA and for anti-glomerular basement membrane antibody, respectively. During the median follow-up of 458.0 days, 55 patients (48.2%) had advanced to end-stage renal disease (ESRD). Cox proportional hazards analysis revealed that patients under the mixed and sclerotic classes had worse renal survival compared to those in the focal class (mixed: hazard ratio [HR], 3.74; 95% confidence interval [CI], 1.18 to 11.82; P = 0.025; sclerotic: HR, 4.84; 95% CI, 1.44 to 16.32; P = 0.011). Severe arteriosclerosis was also associated with poor renal survival (HR, 2.44; 95% CI, 1.04 to 5.77; P = 0.042). TLOs were observed in 41 patients (36.0%). Moreover, TLO formation was also a prognostic factor for ESRD (HR, 1.82; 95% CI, 1.03 to 3.21; P = 0.040). In the multivariate linear regression analysis, age and sclerotic class were independent predictors for the change in estimated glomerular filtration rate during 1 year after biopsy.<h4>Conclusions</h4>Specific histopathologic findings, histopathologic classification, severity of arteriosclerosis, and TLO formation provide helpful information in predicting renal outcomes associated with CrGN.https://doi.org/10.1371/journal.pone.0236051 |
| spellingShingle | Jeong-Hoon Lim Man-Hoon Han Yong-Jin Kim Yena Jeon Hee-Yeon Jung Ji-Young Choi Jang-Hee Cho Chan-Duck Kim Yong-Lim Kim Hajeong Lee Dong Ki Kim Kyung Chul Moon Sun-Hee Park Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis. PLoS ONE |
| title | Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis. |
| title_full | Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis. |
| title_fullStr | Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis. |
| title_full_unstemmed | Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis. |
| title_short | Novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis. |
| title_sort | novel histopathologic predictors for renal outcomes in crescentic glomerulonephritis |
| url | https://doi.org/10.1371/journal.pone.0236051 |
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