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Aydın MF, Yıldız A, Oruç A, Aytaç Vuruşkan B, Akgür S, Ayar Y, Güllülü M, Dilek K, Yavuz M, Ortaç H, Ersoy A. Modified histopathological classification with age-related glomerulosclerosis for predicting kidney survival in ANCA-associated glomerulonephritis. Int Urol Nephrol 2023; 55:741-748. [PMID: 36153782 DOI: 10.1007/s11255-022-03371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/25/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden's ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis. METHODS Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyses were compared according to classical and modified ANCA-GN histopathological classifications. Multivariate Cox regression analysis for the factors affecting renal survival was performed. RESULTS In Berden's ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, eight of the nine patients previously classified in the sclerotic group were classified in the mixed and one in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were significant independent factors. CONCLUSION Modification of Berden's ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.
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Affiliation(s)
- Mehmet Fethullah Aydın
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey.
| | - Abdülmecit Yıldız
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Ayşegül Oruç
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Berna Aytaç Vuruşkan
- Department of Pathology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Suat Akgür
- Division of Nephrology, Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Yavuz Ayar
- Division of Nephrology, Bursa City Hospital, Bursa, Turkey
| | - Mustafa Güllülü
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Kamil Dilek
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Mahmut Yavuz
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Hatice Ortaç
- Department of Biostatistics, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Alparslan Ersoy
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
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