Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea
Abstract This study investigated whether histopathological classification and histologic lesion scores could significantly and independently predict the progression to end-stage kidney disease (ESKD) in Korean patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis-glomerulone...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-09-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41811-0 |
| _version_ | 1797559565531742208 |
|---|---|
| author | Sung-Eun Choi Soo Bin Lee Jung Yoon Pyo Sung Soo Ahn Jason Jungsik Song Yong-Beom Park Beom Jin Lim Sang-Won Lee |
| author_facet | Sung-Eun Choi Soo Bin Lee Jung Yoon Pyo Sung Soo Ahn Jason Jungsik Song Yong-Beom Park Beom Jin Lim Sang-Won Lee |
| author_sort | Sung-Eun Choi |
| collection | DOAJ |
| description | Abstract This study investigated whether histopathological classification and histologic lesion scores could significantly and independently predict the progression to end-stage kidney disease (ESKD) in Korean patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis-glomerulonephritis (AAV-GN). This study included 113 patients with AAV-GN confirmed by kidney biopsy. The glomerular, tubulointerstitial, and vascular lesions were systematically assessed using a scoring system. The scoring system was adopted from the Banff scoring system but also the Oxford study and the revision of the ISN/RPS. For comparison, the scores were classified into two groups; the low, and the high, and the difference was investigated between ESKD and non-ESKD groups using Cox proportional analysis. At diagnosis, the median age was 59.0 years and 33.6% were males. Of 113 patients, 44.2% had ESKD progression during follow-up. There were significant differences in several kidney-, inflammation-, and AAV-pathogenesis-related variables between AAV-GN patients with ESKD and those without. The sclerotic class exhibited the worst renal prognosis among the four histopathological classes. Among histopathological features, high interstitial fibrosis, tubular atrophy and global glomerulitis scores were significantly associated with ESKD progression. Whereas multivariable Cox analysis revealed only a high global glomerulitis score which means global endocapillary hypercellularity in a larger number of glomeruli is an independent predictor of ESKD progression. Moreover, among clinical and histopathological features, a high global glomerulitis score could also predict ESKD progression in addition to serum blood urea nitrogen and creatinine. This study demonstrated the worst renal prognosis for the sclerotic class and first discovered that a high global glomerulitis score was an independent predictor of ESKD in patients with AAV-GN. |
| first_indexed | 2024-03-10T17:47:10Z |
| format | Article |
| id | doaj.art-b6199e02165e4c71887063d0f18eaad8 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T17:47:10Z |
| publishDate | 2023-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-b6199e02165e4c71887063d0f18eaad82023-11-20T09:29:59ZengNature PortfolioScientific Reports2045-23222023-09-0113111110.1038/s41598-023-41811-0Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in KoreaSung-Eun Choi0Soo Bin Lee1Jung Yoon Pyo2Sung Soo Ahn3Jason Jungsik Song4Yong-Beom Park5Beom Jin Lim6Sang-Won Lee7Department of Pathology, CHA University, CHA Bundang Medical CenterDepartment of Medicine, Yonsei University College of MedicineDivision of Rheumatology Department of Internal Medicine, Yonsei University College of MedicineDivision of Rheumatology Department of Internal Medicine, Yonsei University College of MedicineDivision of Rheumatology Department of Internal Medicine, Yonsei University College of MedicineDivision of Rheumatology Department of Internal Medicine, Yonsei University College of MedicineDepartment of Pathology, Gangnam Severance Hospital, Yonsei University College of MedicineDivision of Rheumatology Department of Internal Medicine, Yonsei University College of MedicineAbstract This study investigated whether histopathological classification and histologic lesion scores could significantly and independently predict the progression to end-stage kidney disease (ESKD) in Korean patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis-glomerulonephritis (AAV-GN). This study included 113 patients with AAV-GN confirmed by kidney biopsy. The glomerular, tubulointerstitial, and vascular lesions were systematically assessed using a scoring system. The scoring system was adopted from the Banff scoring system but also the Oxford study and the revision of the ISN/RPS. For comparison, the scores were classified into two groups; the low, and the high, and the difference was investigated between ESKD and non-ESKD groups using Cox proportional analysis. At diagnosis, the median age was 59.0 years and 33.6% were males. Of 113 patients, 44.2% had ESKD progression during follow-up. There were significant differences in several kidney-, inflammation-, and AAV-pathogenesis-related variables between AAV-GN patients with ESKD and those without. The sclerotic class exhibited the worst renal prognosis among the four histopathological classes. Among histopathological features, high interstitial fibrosis, tubular atrophy and global glomerulitis scores were significantly associated with ESKD progression. Whereas multivariable Cox analysis revealed only a high global glomerulitis score which means global endocapillary hypercellularity in a larger number of glomeruli is an independent predictor of ESKD progression. Moreover, among clinical and histopathological features, a high global glomerulitis score could also predict ESKD progression in addition to serum blood urea nitrogen and creatinine. This study demonstrated the worst renal prognosis for the sclerotic class and first discovered that a high global glomerulitis score was an independent predictor of ESKD in patients with AAV-GN.https://doi.org/10.1038/s41598-023-41811-0 |
| spellingShingle | Sung-Eun Choi Soo Bin Lee Jung Yoon Pyo Sung Soo Ahn Jason Jungsik Song Yong-Beom Park Beom Jin Lim Sang-Won Lee Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea Scientific Reports |
| title | Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea |
| title_full | Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea |
| title_fullStr | Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea |
| title_full_unstemmed | Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea |
| title_short | Renal histopathological predictors of end-stage kidney disease in ANCA-associated vasculitis with glomerulonephritis: a single-centre study in Korea |
| title_sort | renal histopathological predictors of end stage kidney disease in anca associated vasculitis with glomerulonephritis a single centre study in korea |
| url | https://doi.org/10.1038/s41598-023-41811-0 |
| work_keys_str_mv | AT sungeunchoi renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT soobinlee renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT jungyoonpyo renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT sungsooahn renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT jasonjungsiksong renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT yongbeompark renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT beomjinlim renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea AT sangwonlee renalhistopathologicalpredictorsofendstagekidneydiseaseinancaassociatedvasculitiswithglomerulonephritisasinglecentrestudyinkorea |