Incidence, Prevalence, Mortality and Chronic Renal Damage of Anti-neutrophil Cytoplasmic Antibody-associated Glomerulonephritis in a 20-year Population-based Cohort

Overview

Journal Nephrol Dial Transplant

Publisher Oxford University Press

Specialties General Surgery
Nephrology

Date 2018 Aug 14

PMID 30102330

Citations 28

Authors

Alvise Berti

Emilie Cornec-Le Gall

Divi Cornec

Marta Casal Moura

Eric L Matteson

Cynthia S Crowson

Aishwarya Ravindran

Sanjeev Sethi

Fernando C Fervenza

Ulrich Specks

Affiliations

Soon will be listed here.

Abstract

Background: True population-based clinical and outcomes data are lacking for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis (AAGN). Therefore we aimed to estimate the incidence, prevalence and mortality of AAGN, as well as the relationship between the grade of chronic renal damage at presentation and renal and non-renal outcomes.

Methods: Patients with AAGN were identified among a population-based incident cohort of 57 Olmsted County residents diagnosed with ANCA-associated vasculitis (AAV) in 1996-2015. Incidence rates were age and sex adjusted to the 2010 US white population. Age- and sex-adjusted prevalence was calculated for 1 January 2015. Survival rates were compared with expected rates in the Minnesota population. Chronic renal damage was assessed by chronicity score (CS) on biopsies performed at diagnosis.

Results: Thirty-four (60%) patients had AAGN. Of these, 65% had microscopic polyangiitis (MPA) and 74% were myeloperoxidase (MPO)-ANCA positive. The annual incidence of AAGN was 2.0/100 000 population [95% confidence interval (CI) 1.3-2.7] and the overall prevalence was 35/100 000 (95% CI 24-47). Mortality for AAGN was increased (P < 0.001), whereas mortality for AAV without glomerulonephritis did not differ from the general population. Minimal to mild CS predicted recovery of renal function at 1 year; clinical diagnosis (granulomatosis with polyangiitis versus MPA) and ANCA specificity (proteinase 3 versus MPO) did not. This observation was replicated in an independent cohort of 38 newly diagnosed AAGN patients seen at our centre over the 1999-2014 period.

Conclusions: The annual incidence and prevalence of AAGN in Minnesota are 2.0/100 000 and 35/100 000, respectively. Mortality is worse compared with AAV patients without glomerulonephritis. More advanced renal damage at diagnosis predicts less renal recovery.

Citing Articles

Validation and modification of renal risk score for prediction of long-term kidney survival in patients with MPO-ANCA-associated glomerulonephritis.

Yang M, Liu X, Chen Y, Chen X, Xu F, Liu Z J Nephrol. 2024; 38(1):215-224.

PMID: 39576457 DOI: 10.1007/s40620-024-02134-z.

The value of the current histological scores and classifications of ANCA glomerulonephritis in predicting long-term outcome.

Stella M, Locatelli L, Sala F, Reggiani F, Calatroni M, LImperio V Clin Kidney J. 2024; 17(7):sfae125.

PMID: 38962252 PMC: 11217817. DOI: 10.1093/ckj/sfae125.

Outcomes of Renal Transplantation in ANCA-Associated Vasculitis.

Long X, Yang X, Yao S, Wu J Ann Transplant. 2024; 29:e943433.

PMID: 38528671 PMC: 10981353. DOI: 10.12659/AOT.943433.

Significance of the total renal chronicity score in predicting renal outcome in PLA2R-associated membranous nephropathy.

Ren W, Sun J, Zhang L, He W, Guo Z, Bian Q J Nephrol. 2024; 37(4):1051-1061.

PMID: 38512370 DOI: 10.1007/s40620-024-01893-z.

Long-term outcome of kidney function in patients with ANCA-associated vasculitis.

Sachez-Alamo B, Moi L, Bajema I, Berden A, Flossmann O, Hruskova Z Nephrol Dial Transplant. 2024; 39(9):1483-1493.

PMID: 38268409 PMC: 11361807. DOI: 10.1093/ndt/gfae018.

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