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Published in: Clinical and Experimental Nephrology 7/2024

Open Access 08-06-2024 | Granulomatosis with Polyangiitis | Rapid communication

Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment

Authors: Akiko Owaki, Akihito Tanaka, Kazuhiro Furuhashi, Yu Watanabe, Eri Koshi-Ito, Takahiro Imaizumi, Shoichi Maruyama

Published in: Clinical and Experimental Nephrology | Issue 7/2024

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Abstract

Background

Kidney and life outcomes remain unsatisfactory in patients with microscopic polyangiitis (MPA). Appropriate treatment intensity must be provided to the appropriate patients. To identify severe cases early, we investigated the factors related to kidney and life outcomes.

Methods

We included patients diagnosed with MPA based on myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) positivity and kidney histopathology results after kidney biopsies between January 1, 2021, and May 11, 2023, at 10 affiliated centers, including our hospital. Death, maintenance dialysis, and estimated glomerular filtration rate (eGFR) < 15 after 6 months of treatment were defined as poor prognosis groups, and factors associated with these conditions were investigated.

Results

We included 84 (36 men and 48 women) patients in this study. Median age was 73.8 (interquartile range: 71–81) years. After 6 months of treatment, the proportion of patients in the poor prognosis group was 16.7 %, with a mortality of 7.1 % and a poor kidney prognosis rate of 9.5 %. Area under the receiver operating characteristic curve showed that eGFR at 2 weeks had a comparable prognostic performance equal as eGFR at 4 weeks (area under the curve: 0.875 and 0.896, respectively). After adjustment by various factors, eGFR at 2 weeks was related with prognosis significantly (p = 0.031).

Conclusion

Kidney function 2 weeks after the start of treatment for MPA can predict prognosis.
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Metadata
Title
Prognosis of microscopic polyangiitis is well predictable in the first 2 weeks of treatment
Authors
Akiko Owaki
Akihito Tanaka
Kazuhiro Furuhashi
Yu Watanabe
Eri Koshi-Ito
Takahiro Imaizumi
Shoichi Maruyama
Publication date
08-06-2024
Publisher
Springer Nature Singapore
Published in
Clinical and Experimental Nephrology / Issue 7/2024
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-024-02522-6

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