Histopathological classification of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis in a nationwide Japanese prospective 2-year follow-up cohort study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10-10

AUTHORS

Kunihiro Yamagata, Joichi Usui, Michio Nagata, Hitoshi Sugiyama, Ken-ei Sada, Eri Muso, Masayoshi Harigai, Koichi Amano, Tatsuya Atsumi, Shouichi Fujimoto, Yukio Yuzawa, Masaki Kobayashi, Takao Saito, Takafumi Ito, Nobuhito Hirawa, Sakae Homma, Hiroaki Dobashi, Naotaka Tsuboi, Akihiro Ishizu, Yoshihiro Arimura, Hirofumi Makino, Seiichi Matsuo

ABSTRACT

BackgroundThe prognostic value of the EUVAS-proposed histopathological classification of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis has been evaluated throughout the world. Here, we performed a Japanese nationwide biopsy survey to assess the association between this histopathological classification and renal prognosis after 2-year follow-up in ANCA-associated glomerulonephritis.MethodsWe collected 67 renal biopsy materials of the 321 entries in the RemIT-JAV-RPGN cohort study, and assessed their histologies. Based on the EUVAS-proposed histopathological classification and some histological parameters, we statistically evaluated renal survival and the comparison of renal function for 2 years.ResultsBased on the histopathological classification, the largest number of biopsy samples belonged to the Focal class, followed by the Mixed, Crescentic, and Sclerotic classes (n = 30, 19, 10, 8, respectively). Although the number of events might be too low (four patients with renal death) to make this conclusion, the Focal and Mixed classes had higher renal-survival rates compared to the others in the renal-survival curve. Comparing renal function among all classes, the estimated glomerular filtration rate (eGFR) throughout 2-year follow-up period was significantly higher in the Focal class compared to the other 3 classes. The eGFR-values in the Crescentic, Mixed, and Sclerotic classes increased with time. Based on both combined results, the Focal class could be the best prognosis.ConclusionThis histopathological classification was valuable for both the stratification of renal function and the estimation of partial renal survival during 2-year follow-up in ANCA-associated glomerulonephritis. More... »

PAGES

387-394

Journal

TITLE

Clinical and Experimental Nephrology

ISSUE

3

VOLUME

23

Author Affiliations

  • Department of Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki, Japan
  • Department of Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
  • Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
  • Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
  • Center for Nephrology and Urology, Division of Nephrology and Dialysis, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
  • Department of Pharmacovigilance, Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
  • Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
  • Division of Rheumatology, Endocrinology and Nephrology at the Graduate School of Medicine, Hokkaido University, Sapporo, Japan
  • Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
  • Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Japan
  • Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, Ami, Japan
  • Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
  • Division of Nephrology, Faculty of Medicine, Shimane University, Izumo, Japan
  • Department of Hemodialysis and Apheresis, Yokohama City University Medical Center, Yokohama, Japan
  • Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
  • Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
  • Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
  • Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
  • Kichijoji Asahi Hospital, Tokyo, Japan
  • Okayama University, Okayama, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10157-018-1656-1

    DOI

    http://dx.doi.org/10.1007/s10157-018-1656-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1107537281

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30306344


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