Clinical and pathological analysis of 101 cases of ANCA-associated vasculitic kidney injury

Objective

To analyze the clinical and pathological features of patients with anti-neutrophilic cytoplasmic antibody (ANCA)-associated vasculitic (AASV)-kidney injury (AASVKI).

Methods

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.

Results

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).

Conclusions

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.