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Histologic and Clinical Factors Associated with Kidney Outcomes in IgA Vasculitis Nephritis
SJ. Barbour, R. Coppo, L. Er, E. Pillebout, ML. Russo, CE. Alpers, AB. Fogo, F. Ferrario, JC. Jennette, ISD. Roberts, HT. Cook, J. Ding, B. Su, X. Zhong, FC. Fervenza, L. Zand, L. Peruzzi, L. Lucchetti, R. Katafuchi, Y. Shima, N. Yoshikawa, D....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
Grantová podpora
Cedars-Sinai Medical Center
NLK
Free Medical Journals
od 2006 do Před 1 rokem
PubMed Central
od 2008 do Před 1 rokem
Europe PubMed Central
od 2008 do Před 1 rokem
Open Access Digital Library
od 2006-01-01
- MeSH
- biopsie MeSH
- dítě MeSH
- dospělí MeSH
- hodnoty glomerulární filtrace MeSH
- IgA nefropatie * komplikace farmakoterapie patologie MeSH
- IgA vaskulitida * komplikace farmakoterapie patologie MeSH
- ledviny patologie MeSH
- lidé MeSH
- mladiství MeSH
- nefritida * komplikace MeSH
- proteinurie etiologie MeSH
- retrospektivní studie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Nephritis is a common manifestation of IgA vasculitis and is morphologically indistinguishable from IgA nephropathy. While MEST-C scores are predictive of kidney outcomes in IgA nephropathy, their value in IgA vasculitis nephritis has not been investigated in large multiethnic cohorts. METHODS: Biopsies from 262 children and 99 adults with IgA vasculitis nephritis ( N =361) from 23 centers in North America, Europe, and Asia were independently scored by three pathologists. MEST-C scores were assessed for correlation with eGFR/proteinuria at biopsy. Because most patients ( N =309, 86%) received immunosuppression, risk factors for outcomes were evaluated in this group using latent class mixed models to identify classes of eGFR trajectories over a median follow-up of 2.7 years (interquartile range, 1.2-5.1). Clinical and histologic parameters associated with each class were determined using logistic regression. RESULTS: M, E, T, and C scores were correlated with either eGFR or proteinuria at biopsy. Two classes were identified by latent class mixed model, one with initial improvement in eGFR followed by a late decline (class 1, N =91) and another with stable eGFR (class 2, N =218). Class 1 was associated with a higher risk of an established kidney outcome (time to ≥30% decline in eGFR or kidney failure; hazard ratio, 5.84; 95% confidence interval, 2.37 to 14.4). Among MEST-C scores, only E1 was associated with class 1 by multivariable analysis. Other factors associated with class 1 were age 18 years and younger, male sex, lower eGFR at biopsy, and extrarenal noncutaneous disease. Fibrous crescents without active changes were associated with class 2. CONCLUSIONS: Kidney outcome in patients with biopsied IgA vasculitis nephritis treated with immunosuppression was determined by clinical risk factors and endocapillary hypercellularity (E1) and fibrous crescents, which are features that are not part of the International Study of Diseases of Children classification.
Bambino Gesù Children's Hospital IRCCS Rome Italy
BC Renal Vancouver British Columbia Canada
Centre for Research on Inflammation Bichat Hospital Inserm and Université Paris Cité Paris France
Clinical Research Center Takatsuki General Hospital Wakayam Medical University Takatsuki City Japan
Comitato Tecnico Scientifico per la Ricerca e Innovaziione A O Santobono Pausilipon Naples Italy
Department of Cellular Pathology Oxford University Hospitals NHS FT Oxford United Kingdom
Department of Children and Adolescents Oulu University Hospital Oulu Finland
Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota
Department of Medicine and Surgery IRCCS San Gerardo University Milan Bicocca Monza Italy
Department of Nephrology 1st Faculty of Medicine General University Hospital Prague Czech Republic
Department of Nephrology and Hypertension Jikei University School of Medicine Tokyo Japan
Department of Nephrology Juntendo University Faculty of Medicine Tokyo Japan
Department of Pathology and Laboratory Medicine Cedars Sinai Medical Center Los Angeles California
Department of Pathology and Medical Biology University of Groningen Groningen The Netherlands
Department of Pathology AP HP Hôpital Bichat Université Paris Cité Paris France
Department of Pathology Johns Hopkins University School of Medicine Baltimore Maryland
Department of Pathology Mass General Brigham Salem Hospital Salem Massachusetts
Department of Pathology The Jikei University School of Medicine Tokyo Japan
Department of Pathology University of Kentucky Medical Center Lexington Kentucky
Department of Pathology University of Toronto Toronto Ontario Canada
Department of Pathology University of Utah Salt Lake City Utah
Department of Pathology Washington University in Saint Louis St Louis Missouri
Department of Pediatrics Peking University 1st Hospital Beijing China
Department of Pediatrics University of Tennessee Health Sciences Center Memphis Tennessee
Department of Pediatrics Wakayama Medical University Wakayama Japan
Division of Dialysis Department of Nephrology University of Miyazaki Hospital Miyazaki Japan
Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota
Division of Nephrology Bambino Gesù Children's Hospital IRCCS Rome Italy
Division of Nephrology University of British Columbia Vancouver British Columbia Canada
Division of Pediatric Nephrology Department of Pediatrics University of Utah Salt Lake City Utah
Division of Pediatric Nephrology University of British Columbia Vancouver British Columbia Canada
Fondazione Ricerca Molinette Regina Margherita Hospital Turin Italy
Imperial College London London United Kingdom
INSERM U1149 and Université Paris Cité Paris France
Institute of Pathology University Hospital of Cologne Cologne Germany
Kidney Unit National Hospital Organization Fukuokahigashi Medical Center Fukuoka Japan
Laboratory of Electron Microscopy Pathological Center Peking University 1st Hospital Beijing China
Nephrology and Dialysis Unit AOU G Martino University of Messina Messina Italy
Nephrology and Dialysis Unit Meyer Children's Hospital Florence Italy
Nephrology Bichat Hospital AP HP Paris France
Nephrology Unit Saint Louis Hospital Paris France
Pathology Department Bambino Gesù Children's Hospital Rome Italy
Pathology Unit Città della Salute e della Scienza di Torino University Hospital Turin Italy
Pathology University Oulu and Oulu University Hospital Oulu Finland
Pediatrics Clinical Trials Office University of Utah Salt Lake City Utah
Citace poskytuje Crossref.org
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