Long-term Prognosis of Anti-Neutrophil Cytoplasmic Antibody-Negative Renal Vasculitis: Cohort Study in Korea.
10.3346/jkms.2016.31.4.542
- Author:
Sung Woo LEE
1
;
Mi Yeon YU
;
Seon Ha BAEK
;
Shin Young AHN
;
Sejoong KIM
;
Ki Young NA
;
Dong Wan CHAE
;
Ho Jun CHIN
Author Information
1. Department of Immunology, Seoul National University Postgraduate School, Seoul, Korea. mednep@snubh.org
- Publication Type:Original Article
- Keywords:
Anti-Neutrophil Cytoplasmic Antibody (ANCA);
Kidney Failure, Chronic;
Vasculitis;
Mortality;
Sex;
Proteinuria;
Koreans;
Prognosis;
Survival;
Cohort Studies
- MeSH:
Age Factors;
Aged;
Antibodies, Antineutrophil Cytoplasmic/*analysis;
Cohort Studies;
Enzyme-Linked Immunosorbent Assay;
Female;
Follow-Up Studies;
Humans;
Kaplan-Meier Estimate;
Kidney Diseases/*diagnosis/mortality;
Kidney Failure, Chronic/etiology;
Male;
Microscopy, Fluorescence;
Middle Aged;
Prognosis;
Proportional Hazards Models;
Republic of Korea;
Retrospective Studies;
Risk Factors;
Severity of Illness Index;
Sex Factors;
Vasculitis/complications/*diagnosis/mortality
- From:Journal of Korean Medical Science
2016;31(4):542-546
- CountryRepublic of Korea
- Language:English
-
Abstract:
Few studies have reported on the long-term prognosis of anti-neutrophil cytoplasmic antibody (ANCA)-negative renal vasculitis. Between April 2003 and December 2013, 48 patients were diagnosed with renal vasculitis. Their ANCA status was tested using indirect immunofluorescence and enzyme-linked immunosorbent assays. During a median (interquartile range) follow-up duration of 933.5 (257.5-2,079.0) days, 41.7% of patients progressed to end stage renal disease (ESRD) and 43.8% died from any cause. Of 48 patients, 6 and 42 were ANCA-negative and positive, respectively. The rate of ESRD within 3 months was higher in ANCA-negative patients than in ANCA-positive patients (P = 0.038). In Kaplan-Meier survival analysis, ANCA-negative patients showed shorter renal survival than did ANCA-positive patients (log-rank P = 0.033). In univariate Cox-proportional hazard regression analysis, ANCA-negative patients showed increased risk of ESRD, with a hazard ratio 3.190 (95% confidence interval, 1.028-9.895, P = 0.045). However, the effect of ANCA status on renal survival was not statistically significant in multivariate analysis. Finally, ANCA status did not significantly affect patient survival. In conclusion, long-term patient and renal survival of ANCA-negative renal vasculitis patients did not differ from those of ANCA-positive renal vasculitis patients. Therefore, different treatment strategy depending on ANCA status might be unnecessary.
