首页|Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis:a nationwide retrospective study in China

Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis:a nationwide retrospective study in China

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Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vas-culitis featured by liability to renal involvement.However,there are few studies on the risk factors and predictive models for renal outcomes of AAV in children.Methods Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospec-tively.The risk factors and predictive model of end-stage renal disease(ESRD)in AAV were explored.Results Renal involvement was the most typical manifestation(95.5%),and the crescent was the predominant pathological lesion(84.9%).The estimated glomerular filtration rate(eGFR)was evaluated in 114 patients,of whom 59.6%developed ESRD,and the median time to ESRD was 3.20 months.The eGFR[P=0.006,odds ratio(OR)=0.955,95%confidence inter-val(CI)=0.924-0.987]and the percentages of global glomerulosclerosis(pGGS;P=0.018,OR=1.060,95%CI=1.010-1.112)were independent risk factors for ESRD of renal biopsy.Based on the pGGS and eGFR at renal biopsy,we developed three risk grades of ESRD and one predictive model.The Kaplan-Meier curve indicated that renal outcomes were signifi-cantly different in different risk grades(P<0.001).Compared with serum creatinine at baseline,the predictive model had higher accuracy(0.86 versus 0.58,P<0.001)and a lower coefficient of variation(0.07 versus 0.92)in external validation.Conclusions Renal involvement is the most common manifestation of pediatric AAV in China,of which more than half deteriorates into ESRD.The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children.

Antineutrophil cytoplasmic antibodyEnd-stage renal diseaseGlomerulonephritisPediatric nephrologyVasculitis

Li-Wen Tan、Jun-Li Wan、Chun-Hua Zhu、Hong Xu、Zheng-Kun Xia、Li-Zhi Chen、Xiao-Chuan Wu、Fang Wang、Xiao-Rong Liu、Cheng-Guang Zhao、Xiao-Zhong Li、Jian-Hua Mao、Xiao-Wen Wang、Wen-Yan Huang、Yu-Hong Li、Jian-Jiang Zhang、Shi-Pin Feng、Jun Yang、Jiao-Jiao Liu、Chun-Lin Gao、Li-Ping Rong、Lan-Jun Shuai、Ke Xu、He-Jia Zhang、Qiu Li、Ai-Hua Zhang、Mo Wang

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Department of Nephrology,Children's Hospital of Chongqing Medical University,Zhongshan 2nd Rd.136,Chongqing 400014,China

Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Children's Hospital of Chongqing Medical University,Chongqing,China

Chongqing Key Laboratory of Pediatrics,Children's Hospital of Chongqing Medical Un

Department of Nephrology,Children's Hospital of Nanjing Medical University,72 Guangzhou Road,Nanjing 210008,China

Department of Nephrology,Children's Hospital of Fudan University,National Paediatric Medical Center of China,Shanghai,China

Department of Pediatrics,Jinling Hospital,Nanjing Medical University,Nanjing,China

Department of Pediatrics,Jinling Hospital,The First School of Clinical Medicine,Southern Medical University,Nanjing,China

Department of Pediatrics,Jinling Hospital,Medical School of Nanjing University,Nanjing,China

Department of Pediatric Nephrology and Rheumatology,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,China

Department of Pediatrics,The Second Xiangya Hospital of Central South University,Changsha,China

Department of Pediatrics,Peking University First Hospital,Beijing,China

Department of Nephrology,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China

National Center for Children's Health,Beijing,China

Department of Pediatrics,Shengjing Hospital of China Medical University,Shenyang,China

Department of Nephrology and Immunology,Children's Hospital of Soochow University,Suzhou,China

Department of Nephrology,Children Hospital,Zhejiang University School of Medicine,Hangzhou,China

Department of Nephrology,Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science &Technology,Wuhan,China

Department of Nephrology and Rheumatology,Shanghai Children's Hospital,School of medicine,Shanghai Jiao Tong University,Shanghai,China

Pediatric Nephrology Department,Guiyang Maternal &Child Health Care Hospital,Guiyang,China

Department of Pediatrics,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,China

Department of Nephrology,Chengdu Women and Children Central Hospital,Chengdu 610041,China

Department of Rheumatology and Immunology,Shenzhen Children's Hospital,Shenzhen,China

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国家重点研发计划国家重点研发计划Key Research and Development Projects of Jiangsu ProvinceNational Clinical Research Center for Child Health and Disorders

2021YFC27020022022YFC2705100BE2021607NCRCCHD-2020-GP-01

2024

世界儿科杂志(英文版)

世界儿科杂志(英文版)

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ISSN:
年,卷(期):2024.20(5)
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