Mehmet Fethullah Aydın1, Abdülmecit Yıldız2, Ayşegül Oruç2, Berna Aytaç Vuruşkan3, Suat Akgür4, Yavuz Ayar5, Mustafa Güllülü2, Kamil Dilek2, Mahmut Yavuz2, Hatice Ortaç6, Alparslan Ersoy2. 1. Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey. mfaydin@uludag.edu.tr. 2. Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey. 3. Department of Pathology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey. 4. Division of Nephrology, Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital, Kütahya, Turkey. 5. Division of Nephrology, Bursa City Hospital, Bursa, Turkey. 6. Department of Biostatistics, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey.
Abstract
BACKGROUND: The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden's ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis. METHODS: Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyses were compared according to classical and modified ANCA-GN histopathological classifications. Multivariate Cox regression analysis for the factors affecting renal survival was performed. RESULTS: In Berden's ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, eight of the nine patients previously classified in the sclerotic group were classified in the mixed and one in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were significant independent factors. CONCLUSION: Modification of Berden's ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.
BACKGROUND: The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden's ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis. METHODS: Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyses were compared according to classical and modified ANCA-GN histopathological classifications. Multivariate Cox regression analysis for the factors affecting renal survival was performed. RESULTS: In Berden's ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, eight of the nine patients previously classified in the sclerotic group were classified in the mixed and one in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were significant independent factors. CONCLUSION: Modification of Berden's ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.
Authors: Annelies E Berden; Franco Ferrario; E Christiaan Hagen; David R Jayne; J Charles Jennette; Kensuke Joh; Irmgard Neumann; Laure-Hélène Noël; Charles D Pusey; Rüdiger Waldherr; Jan A Bruijn; Ingeborg M Bajema Journal: J Am Soc Nephrol Date: 2010-07-08 Impact factor: 10.121
Authors: Luis F Quintana; Nuria S Peréz; Erika De Sousa; Lida M Rodas; Meryl H Griffiths; Manel Solé; David Jayne Journal: Nephrol Dial Transplant Date: 2014-04-19 Impact factor: 5.992
Authors: J C Jennette; R J Falk; P A Bacon; N Basu; M C Cid; F Ferrario; L F Flores-Suarez; W L Gross; L Guillevin; E C Hagen; G S Hoffman; D R Jayne; C G M Kallenberg; P Lamprecht; C A Langford; R A Luqmani; A D Mahr; E L Matteson; P A Merkel; S Ozen; C D Pusey; N Rasmussen; A J Rees; D G I Scott; U Specks; J H Stone; K Takahashi; R A Watts Journal: Arthritis Rheum Date: 2013-01