Department of Nephrology, The First Hospital of Jilin University, Changchun, 130031, China.
Department of Pathology, The First Hospital of Jilin University, Changchun, 130031, China.
Int Urol Nephrol. 2021 Oct;53(10):2099-2106. doi: 10.1007/s11255-021-02793-y. Epub 2021 Mar 5.
To analyze the clinical and pathological features of patients with anti-neutrophilic cytoplasmic antibody (ANCA)-associated vasculitic (AASV)-kidney injury (AASVKI).
From January 2015 to December 2018, a total of 101 AASVKI patients treated in the First Hospital of Jilin University were divided into 2 groups (the pANCA-positive group and the cANCA-positive group) for comparison; 63 patients were performed renal biopsy and divided into 3 groups according to pathological results [the non-crescent nephritis group (non-C), the crescent nephritis group (C), and the sclerotic nephritis group (S)] for comparison.
Compared with the Group pANCA, Group cANCA exhibited higher incidence of eye involvement (P = 0.039) and skin mucosa destruction (P = 0.045), higher serum creatinine (Scr) (P < 0.001), higher 24-h urine protein quantification (P = 0.045), but lower hemoglobin (Hb) (P < 0.001). Compared with Group non-C, Group C had higher Scr (P < 0.001) and urinary red blood cells (P = 0.010), lower estimated glomerular filtration rate (eGFR) (P = 0.003), hemoglobin (HD)-dependence (P = 0.042), and higher mortality rate within 1 year (P = 0.005); compared with Group S, Group C had faster onset of erythrocyte sedimentation rate (ESR) (P = 0.031), higher urinary red blood cells (P = 0.029), and lower incidence of HD-dependence (P = 0.038).
AASVKI patients with positive cANCA have poor renal function, among whom the patients with crescent type have poorer renal function than those with non-crescent type, have higher urinary red blood cells while lower HD-dependence than those with sclerotic type.
分析抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AASV）-肾损伤（AASVKI）患者的临床和病理特征。
回顾性分析 2015 年 1 月至 2018 年 12 月在吉林大学第一医院接受治疗的 101 例 AASVKI 患者的临床资料，根据抗中性粒细胞胞浆抗体（ANCA）检测结果将患者分为 pANCA 阳性组和 cANCA 阳性组，并对其中行肾活检的 63 例患者根据病理结果进一步分为非新月体肾炎组（non-C）、新月体肾炎组（C）和硬化性肾炎组（S），比较各组患者的临床和病理特点。
与 pANCA 阳性组相比，cANCA 阳性组患者眼部受累（P=0.039）和皮肤黏膜破坏（P=0.045）发生率更高，血清肌酐（Scr）（P<0.001）、24 h 尿蛋白定量（P=0.045）更高，血红蛋白（Hb）（P<0.001）更低。与 non-C 组相比，C 组患者 Scr（P<0.001）和尿红细胞（P=0.010）更高，估算肾小球滤过率（eGFR）（P=0.003）、血红蛋白（Hb）依赖（P=0.042）更低，1 年内死亡率（P=0.005）更高；与 S 组相比，C 组患者红细胞沉降率（ESR）（P=0.031）更快，尿红细胞（P=0.029）更高，Hb 依赖发生率（P=0.038）更低。
cANCA 阳性的 AASVKI 患者肾功能较差，其中新月体肾炎患者的肾功能较非新月体肾炎患者更差，尿红细胞更多，而对 HD 治疗的依赖率更低。
