Improved outcome in anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis: a 30-year follow-up study
- 6 December 2012
- journal article
- Published by Oxford University Press (OUP) in Nephrology Dialysis Transplantation
- Vol. 28 (2), 373-379
- https://doi.org/10.1093/ndt/gfs428
Abstract
Background Anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis has a poor prognosis. In the current study, we assessed whether prognosis in these patients improved over the last three decades. Methods In a large inception cohort, all consecutive patients with ANCA-associated glomerulonephritis were included between January 1979 and December 2009. Inclusion criteria were the presence of ANCA and the availability of a kidney biopsy. To assess renal and patient survival, patients were divided in three groups through time: 1979–89, 1990–2000 and 2001–09. Results A total of 181 patients were included. One-, 5- and 10-year survival was 77, 66 and 49%, respectively. Survival within the time groups was significantly different, yielding a hazard ratio for death of 2.9 for 1990–2000 and 3.9 for 1979–89 compared with 2001–09 (P < 0.001). Serum creatinine and active lesions as found in the kidney biopsy significantly decreased through the three decades. Conclusions Both patient and renal survival in patients with ANCA-associated renal vasculitis have improved over the last three decades. We postulate that both earlier diagnosis and better therapeutic management of patients are responsible for this effect.This publication has 29 references indexed in Scilit:
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