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Evaluation of a newly proposed renal risk score for Japanese patients with ANCA-associated glomerulonephritis

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Abstract

Background

We determined the usefulness and prognostic ability of the renal risk score (RRS), proposed in Europe, for Japanese patients with antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN) and high myeloperoxidase (MPO)-ANCA positivity; these aspects remain to be verified.

Methods

This retrospective study was conducted on 86 Japanese patients with new, biopsy-confirmed AAGN. We calculated the RRS and analyzed the relationship between this classification, and clinicopathological features and prognosis. We also compared the predictive values between RRS for endpoints including renal death and conventional prognostic tools for patients with AAGN.

Results

There were 33, 37, and 16 patients in the low-, medium-, and high-risk groups, respectively. All patients were MPO-ANCA positive. The median follow-up period was 33 months; 16 (18.6%) patients progressed to end-stage renal disease (ESRD). In the high-risk group, 9/16 (56.3%) patients progressed to ESRD, and renal prognosis was significantly poorer than that in other groups (low-risk group, P < 0.001; medium-risk group, P = 0.004). In Cox multivariate regression analysis, RRS was an independent, poor renal prognostic factor (hazard ratio 5.22; 95% confidence interval 2.20–12.40; P < 0.001). The receiver-operating characteristic curves of the RRS for each endpoint were comparable with those of the 2010 histological classification and those of the severity classification of Japanese rapidly progressive glomerulonephritis.

Conclusions

This is the first study to report the usefulness of the RRS for predicting renal outcomes among Japanese patients with AAGN. Our predictive value of the RRS was comparable with that of conventional prognostic tools.

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Acknowledgements

The authors thank all the doctors at our affiliated hospitals for referral of patients.

Author information

Authors and Affiliations

  1. Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan

    Masaya Saito, Ayano Saito, Fumito Abe, Chihiro Imaizumi, Hajime Kaga, Masato Sawamura, Mizuho Nara & Naoto Takahashi

  2. Department of Internal Medicine, Yuri Kumiai General Hospital, Akita, Japan

    Fumito Abe

  3. Department of Nephrology, Akita Kosei Medical Center, Akita, Japan

    Masatoyo Ozawa & Hiroshi Ohtani

  4. Department of Nephrology, Akita Red Cross Hospital, Akita, Japan

    Ryuta Sato

  5. Department of Nephrology and Rheumatology, Nihonkai General Hospital, Yamagata, Japan

    Takahiro Nakayama

  6. Department of Nephrology and Rheumatology, Nakadori General Hospital, Akita, Japan

    Shin Okuyama

  7. Department of Nephrology, Akita City Hospital, Akita, Japan

    Rie Masai

  8. Department of Internal Medicine and Cardiology, Ogachi Central Hospital, Akita, Japan

    Atsushi Komatsuda

  9. Department of Life Science, Akita University Graduate School of Engineering Science, Akita, Japan

    Hideki Wakui

Authors
  1. Masaya Saito
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  2. Ayano Saito
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  3. Fumito Abe
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  10. Takahiro Nakayama
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  11. Shin Okuyama
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  15. Hideki Wakui
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  16. Naoto Takahashi
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Corresponding author

Correspondence to Masaya Saito.

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The authors declare that no conflicts of interest exists.

Ethical approval

All the procedures were performed in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 1830), as well as the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the individual participants included in the study.

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Saito, M., Saito, A., Abe, F. et al. Evaluation of a newly proposed renal risk score for Japanese patients with ANCA-associated glomerulonephritis. Clin Exp Nephrol 26, 760–769 (2022). https://doi.org/10.1007/s10157-022-02217-w

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  • DOI: https://doi.org/10.1007/s10157-022-02217-w

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