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Histopathologic classification reveals renal outcomes in AAV patients

17 Mar 2017

Histopathologic classification appears to be useful in determining renal outcome in patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV), suggests a recent study. Additionally, results of a meta-analysis shows that patients with focal class have the best outcome while those with sclerotic class have the worst.

“Renal vasculitis is one of the most common manifestations of AAV, and renal histology is a key predictor of the outcome,” researchers said.

A retrospective analysis was performed to validate the histopathologic classification, and a meta-analysis was conducted to evaluate its predictive value. A total of 186 patients with ANCA-associated renal vasculitis diagnosed at Ruijin Hospital were enrolled in the retrospective study. Meanwhile, data for 1,601 patients were considered for the meta-analysis.

Findings from the retrospective study revealed that patients with focal class had the best renal outcome, while those with mixed class had the worst (p<0.001). In the meta-analysis, patients with focal class had better renal outcome than did those with crescentic class (risk ratio [RR], 0.23; 95 percent CI, 0.16 to 0.34; p<0.00001), with no evidence of heterogeneity (I2=0 percent; p=0.96).

Moreover, patients with crescentic class had better renal outcome than did those with sclerotic class (RR, 0.52; 0.41 to 0.64; p<0.00001), with no evidence of heterogeneity (I2=2 percent; p=0.43). There was no statistically significant difference in the renal outcome between mixed and crescentic classes (RR, 1.14; 0.91 to 1.43; p=0.27), with no evidence of heterogeneity (I2=23 percent; p=0.19).

The most common extrarenal manifestations were lung and upper respiratory tract involvement, according to researchers.

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