Skip to main content

Advertisement

SpringerLink
Log in

Systemic inflammation response index predicts all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Objectives

A systemic inflammation response index (SIRI) has been recently introduced as a tool for the assessment of the prognosis of several critical medical conditions. In this study, we investigated whether SIRI at diagnosis could estimate the cross-sectional disease activity and predict poor prognosis during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Methods

We reviewed the medical records of 224 immunosuppressive drug-naïve AAV patients and obtained clinical and laboratory data both at diagnosis and during follow-up. SIRI was calculated using the following equation: SIRI = peripheral blood neutrophil count × monocyte count/lymphocyte count.

Results

The median age of AAV patients at diagnosis was 59.0 years and 33% were male. In the univariable linear regression analysis, SIRI value at diagnosis was not significantly correlated with the cross-sectional Birmingham vasculitis activity score (BVAS) (r = 0.125, P = 0.062). When the SIRI cut-off value at diagnosis was set at 2847.9 mm−3 using the receiver operator characteristic curve, the sensitivity was 56.0% and the specificity was 68.3% for all-cause mortality [area 0.618, 95% confidence interval (CI) 0.502, 0.734]. AAV patients with SIRI ≥ 2847.9 mm−3 had a significantly higher risk for all-cause mortality than those with SIRI < 2847.9 mm−3 [relative risk (RR) 2.747, 95% CI 1.181, 6.392]. During follow-up, AAV patients with SIRI ≥ 2847.9 mm−3 exhibited a significantly lower patients’ survival rate than those with SIRI < 2847.9 mm−3 (P = 0.003).

Conclusions

SIRI at diagnosis could predict all-cause mortality during follow-up but it could not estimate the cross-sectional BVAS in AAV patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Pacheco-Barcia V, Mondéjar Solís R, France T et al (2020) A systemic inflammation response index (SIRI) correlates with survival and predicts oncological outcome for mFOLFIRINOX therapy in metastatic pancreatic cancer. Pancreatology 20(2):254–264

    Article  CAS  Google Scholar 

  2. Zheng Y, Chen Y, Chen J et al (2019) Combination of systemic inflammation response index and platelet-to-lymphocyte ratio as a novel prognostic marker of upper tract urothelial carcinoma after radical nephroureterectomy. Front Oncol 9:914

    Article  Google Scholar 

  3. Jennette JC, Falk RJ, Bacon PA et al (2013) 2012 revised international chapel hill consensus conference nomenclature of vasculitides. Arthritis Rheum 65(1):1–11

    Article  CAS  Google Scholar 

  4. Watts R, Lane S, Hanslik T, Hauser T et al (2007) Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 66(2):222–227

    Article  Google Scholar 

  5. Jennette JC, Falk RJ (2014) Pathogenesis of antineutrophil cytoplasmic autoantibody-mediated disease. Nat Rev Rheumatol 10(8):463–473

    Article  CAS  Google Scholar 

  6. Brunini F, Page TH, Gallieni M, Pusey CD (2016) The role of monocytes in ANCA-associated vasculitides. Autoimmun Rev 15(11):1046–1053

    Article  CAS  Google Scholar 

  7. Mukhtyar C, Lee R, Brown D et al (2009) Modification and validation of the Birmingham vasculitis activity score (version 3). Ann Rheum Dis 68(12):1827–1832

    Article  CAS  Google Scholar 

  8. Guillevin L, Pagnoux C, Seror R et al (2011) The five-factor score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group (FVSG) cohort. Medicine (Baltimore) 90(1):19–27

    Article  Google Scholar 

  9. McAdoo SP, Medjeral-Thomas N, Gopaluni S et al (2019) Long-term follow-up of a combined rituximab and cyclophosphamide regimen in renal anti-neutrophil cytoplasm antibody-associated vasculitis. Nephrol Dial Transplant 34(1):63–73

    Article  CAS  Google Scholar 

  10. Ahn SS, Jung SM, Song JJ, Park YB, Lee SW (2019) Prognostic nutritional index is associated with disease severity and relapse in ANCA-associated vasculitis. Int J Rheum Dis 22(5):797–804

    Article  CAS  Google Scholar 

  11. Park HJ, Jung SM, Song JJ, Park YB, Lee SW (2018) Platelet to lymphocyte ratio is associated with the current activity of ANCA-associated vasculitis at diagnosis: a retrospective monocentric study. Rheumatol Int 38(10):1865–1871

    Article  CAS  Google Scholar 

  12. Ahn SS, Jung SM, Song JJ, Park YB, Lee SW (2018) Neutrophil to lymphocyte ratio at diagnosis can estimate vasculitis activity and poor prognosis in patients with ANCA-associated vasculitis: a retrospective study. BMC Nephrol 19(1):187

    Article  Google Scholar 

  13. O’Brien EC, Abdulahad WH, Rutgers A et al (2015) Intermediate monocytes in ANCA vasculitis: increased surface expression of ANCA autoantigens and IL-1β secretion in response to anti-MPO antibodies. Sci Rep 5:11888

    Article  Google Scholar 

  14. Casselman BL, Kilgore KS, Miller BF, Warren JS (1995) Antibodies to neutrophil cytoplasmic antigens induce monocyte chemoattractant protein-1 secretion from human monocytes. J Lab Clin Med 126(5):495–502

    CAS  PubMed  Google Scholar 

  15. Muller Kobold AC, Kallenberg CG, Tervaert JW (1999) Monocyte activation in patients with Wegener’s granulomatosis. Ann Rheum Dis 58(4):237–245

    Article  CAS  Google Scholar 

  16. Proctor MJ, McMillan DC, Horgan PG, Fletcher CD, Talwar D, Morrison DS (2015) Systemic inflammation predicts all-cause mortality: a glasgow inflammation outcome study. PLoS ONE 10(3):e0116206

    Article  Google Scholar 

  17. Isaac V, Wu CY, Huang CT, Baune BT, Tseng CL, McLachlan CS (2016) Elevated neutrophil to lymphocyte ratio predicts mortality in medical inpatients with multiple chronic conditions. Medicine (Baltimore) 95(23):e3832

    Article  CAS  Google Scholar 

  18. Choi SH, Kim JH, Lim S et al (2017) Monocyte count as a predictor of cardiovascular mortality in older Korean people. Age Ageing 46(3):433–438

    Article  Google Scholar 

Download references

Acknowledgements

This research was supported by a faculty research Grant of Yonsei University College of Medicine (6-2019-0184) and a Grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI14C1324).

Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Lucy Eunju Lee, Jung Yoon Pyo, Sung Soo Ahn, Jason Jungsik Song, Yong-Beom Park & Sang-Won Lee

  2. Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jason Jungsik Song, Yong-Beom Park & Sang-Won Lee

Authors
  1. Lucy Eunju Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jung Yoon Pyo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sung Soo Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jason Jungsik Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yong-Beom Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sang-Won Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sang-Won Lee.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was approved by the Institutional Review Board of Severance Hospital (4-2017-0673) and the patients’ written informed consent was obtained at the time of blood sampling.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, L.E., Pyo, J.Y., Ahn, S.S. et al. Systemic inflammation response index predicts all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis. Int Urol Nephrol 53, 1631–1638 (2021). https://doi.org/10.1007/s11255-020-02777-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-020-02777-4

Keywords

Search

Navigation