Journal Article

Improved outcome in anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis: a 30-year follow-up study

Marc Hilhorst, Benjamin Wilde, Pieter van Paassen, Bjorn Winkens, Peter van Breda Vriesman and Jan Willem Cohen Tervaert

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 28, issue 2, pages 373-379
Published in print February 2013 | ISSN: 0931-0509
Published online December 2012 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfs428
Improved outcome in anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis: a 30-year follow-up study

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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.

Keywords: ANCA; outcome; renal biopsy; survival; vasculitis

Journal Article.  4306 words.  Illustrated.

Subjects: Nephrology

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