Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY Clinical and Experimental Nephrology Pub Date : 2024-07-01 Epub Date: 2024-06-08 DOI:10.1007/s10157-024-02522-6

Akiko Owaki, Akihito Tanaka, Kazuhiro Furuhashi, Yu Watanabe, Eri Koshi-Ito, Takahiro Imaizumi, Shoichi Maruyama

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Abstract

Background: Kidney and life outcomes remain unsatisfactory in patients with microscopic polyangiitis (MPA). Appropriate treatment intensity must be provided to the appropriate patients. To identify severe cases early, we investigated the factors related to kidney and life outcomes.

Methods: We included patients diagnosed with MPA based on myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) positivity and kidney histopathology results after kidney biopsies between January 1, 2021, and May 11, 2023, at 10 affiliated centers, including our hospital. Death, maintenance dialysis, and estimated glomerular filtration rate (eGFR) < 15 after 6 months of treatment were defined as poor prognosis groups, and factors associated with these conditions were investigated.

Results: We included 84 (36 men and 48 women) patients in this study. Median age was 73.8 (interquartile range: 71-81) years. After 6 months of treatment, the proportion of patients in the poor prognosis group was 16.7 %, with a mortality of 7.1 % and a poor kidney prognosis rate of 9.5 %. Area under the receiver operating characteristic curve showed that eGFR at 2 weeks had a comparable prognostic performance equal as eGFR at 4 weeks (area under the curve: 0.875 and 0.896, respectively). After adjustment by various factors, eGFR at 2 weeks was related with prognosis significantly (p = 0.031).

Conclusion: Kidney function 2 weeks after the start of treatment for MPA can predict prognosis.

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显微镜下多血管炎的预后在治疗的头两周是可以预测的。

背景：显微镜下多血管炎（MPA）患者的肾脏和生活质量仍不尽如人意。必须为适当的患者提供适当强度的治疗。为了及早发现重症病例，我们研究了与肾脏和生活质量相关的因素：我们纳入了 2021 年 1 月 1 日至 2023 年 5 月 11 日期间在包括我院在内的 10 家附属中心根据髓过氧化物酶-抗中性粒细胞胞浆抗体（MPO-ANCA）阳性和肾活检后肾组织病理学结果诊断为 MPA 的患者。死亡、维持性透析和估计肾小球滤过率（eGFR）结果：本研究共纳入 84 名患者（36 名男性，48 名女性）。中位年龄为 73.8 岁（四分位数间距：71-81）。治疗 6 个月后，预后不良组的患者比例为 16.7%，死亡率为 7.1%，肾脏预后不良率为 9.5%。接收器操作特征曲线下面积显示，2 周时的 eGFR 与 4 周时的 eGFR 在预后方面的表现相当（曲线下面积分别为 0.875 和 0.896）。经各种因素调整后，2周时的eGFR与预后有显著相关性（p = 0.031）：结论：MPA治疗开始两周后的肾功能可预测预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.