Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
Renal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring...
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doaj-a9dfa7559aa641b6bf1ba7b9232063a42021-02-09T05:22:38ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-02-01710.3389/fmed.2020.622028622028Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care TreatmentSamy Hakroush0Desiree Tampe1Peter Korsten2Philipp Ströbel3Michael Zeisberg4Michael Zeisberg5Björn Tampe6Institute of Pathology, University Medical Center Göttingen, Göttingen, GermanyDepartment of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, GermanyDepartment of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, GermanyInstitute of Pathology, University Medical Center Göttingen, Göttingen, GermanyDepartment of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, GermanyGerman Center for Cardiovascular Research (DZHK), Göttingen, GermanyDepartment of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, GermanyRenal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring RRT at admission, we here aimed to evaluate histopathological findings and predictive value of Berden's histopathological subgrouping and ARRS for severity of AKI and requirement of RRT during the short-term clinical course in critically ill patients requiring intensive care treatment and predictors for short-term renal recovery in patients requiring RRT. A subgroup of 15/46 (32. 6%) AAV patients with biopsy-proven AAV required RRT during the short-term course of disease, associated with requirement of critical care treatment. While histopathological subgrouping and ARRS were associated with requirement of acute RRT, presence of global glomerular scarring was the strongest predictor of failure to recover from RRT after initiation of remission induction therapy. This new aspect requires further investigation in a prospective controlled setting for therapeutic decision making especially in this subgroup.https://www.frontiersin.org/articles/10.3389/fmed.2020.622028/fullautoimmune diseasessystemic vasculitisinflammationANCA-associated vasculitisacute kidney injuryrenal replacement therapy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Samy Hakroush Desiree Tampe Peter Korsten Philipp Ströbel Michael Zeisberg Michael Zeisberg Björn Tampe |
spellingShingle |
Samy Hakroush Desiree Tampe Peter Korsten Philipp Ströbel Michael Zeisberg Michael Zeisberg Björn Tampe Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment Frontiers in Medicine autoimmune diseases systemic vasculitis inflammation ANCA-associated vasculitis acute kidney injury renal replacement therapy |
author_facet |
Samy Hakroush Desiree Tampe Peter Korsten Philipp Ströbel Michael Zeisberg Michael Zeisberg Björn Tampe |
author_sort |
Samy Hakroush |
title |
Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment |
title_short |
Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment |
title_full |
Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment |
title_fullStr |
Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment |
title_full_unstemmed |
Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment |
title_sort |
histopathological findings predict renal recovery in severe anca-associated vasculitis requiring intensive care treatment |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2021-02-01 |
description |
Renal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring RRT at admission, we here aimed to evaluate histopathological findings and predictive value of Berden's histopathological subgrouping and ARRS for severity of AKI and requirement of RRT during the short-term clinical course in critically ill patients requiring intensive care treatment and predictors for short-term renal recovery in patients requiring RRT. A subgroup of 15/46 (32. 6%) AAV patients with biopsy-proven AAV required RRT during the short-term course of disease, associated with requirement of critical care treatment. While histopathological subgrouping and ARRS were associated with requirement of acute RRT, presence of global glomerular scarring was the strongest predictor of failure to recover from RRT after initiation of remission induction therapy. This new aspect requires further investigation in a prospective controlled setting for therapeutic decision making especially in this subgroup. |
topic |
autoimmune diseases systemic vasculitis inflammation ANCA-associated vasculitis acute kidney injury renal replacement therapy |
url |
https://www.frontiersin.org/articles/10.3389/fmed.2020.622028/full |
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