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Estimating the epidemiology of anti-neutrophil cytoplasm antibody-associated renal vasculitis and the role of histologic chronicity in predicting renal outcomes.

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Kronbichler, Andreas  ORCID logo
Jayne, David RW 


In the current issue of Nephrology Dialysis Transplantation, Berti et al. [1] analysed the epidemiology of anti-neutrophil cytoplasm antibody (ANCA) associated renal vasculitis in Olmsted County (Minnesota, USA) and found a higher incidence compared to other previous reports. Increased mortality risk was strongly influenced by renal disease, whereas those without renal vasculitis had a comparable mortality rate to the general population. Renal biopsies were scored according to a Chronicity Score (CS) based on a Mayo Clinic/RPS consensus report. Patients with a low CS had a higher probability of better renal function recovery over a 12-month follow-up period compared to those with a high CS. These findings were corroborated in an independent replication cohort. No differences between ANCA serotypes (PR3 or MPO-ANCA) regarding renal recovery were observed. While these results argue for the inclusion of tubulointerstitial changes to the current histolopathologic classification based on glomerular pathology, these findings warrant further confirmation in larger cohorts. In this Editorial, we focus on the influence of histology on renal prognosis and discuss the impact of renal disease on prognosis in ANCA associated vasculitis.



Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Antibodies, Antineutrophil Cytoplasmic, Cytoplasm, Glomerulonephritis, Humans, Incidence, Prevalence

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Nephrol Dial Transplant

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Oxford University Press (OUP)


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