Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients

Herbert A. Hauer; Ingeborg M. Bajema; Hans C. Van Houwelingen; Franco Ferrario; Laure Hélène Noël; R. Waldherr; David R.W. Jayne; N. Rasmussen; Jan A. Bruijn; E. Christiaan Hagen; N. Rasmussen; D. R.W. Jayne; I. Neumann; P. Mad-Houn; J. Sennesael; V. Tesar; I. Rychlik; J. Bartunkova; J. Luk; B. Ravn Juhl; J. Petersen; C. B. Andersen; W. Szpirt; A. Wiik; H. Lokkegaard; H. Nielsen; T. Ring; S. Freiesleben Sorensen; P. A. Bacon; A. Exley; C. O.S. Savage; G. Gaskin; C. Pusey; C. M. Lockwood; R. Luq-Mani; C. Gronhagen-Riska; A. Ekstrand; L. Guillevin; F. Lhote; P. Lesavre; L. H. Noel; P. Landais; P. Vanhille; P. Bataille; V. Esnault; F. Van Der Woude; R. Waldherr; W. Schmitt; K. Andrassy; O. Hergesell; R. Nowack; K. De Groot; K. Herlyn; W. L. Gross; K. A. Boki; J. N. Boletis; D. S. Emmanouel; C. Feighery; Y. Ferra-Rio; R. A. Sinico; G. Gregorini; J. Dadoniene; E. C. Hagen; C. G.M. Kallenberg; C. Stegeman; J. W.Cohen Tervaert; C. A. Verburgh; C. E.H. Siegert; J. A. Bruijn; H. A. Hauer; J. Hermans; J. C.Van Houwelingen; C. E. Vergunst; E. Van Gurp; I. M. Bajema; C. Vasconcelos; E. Mirapeix; M. Sole; E. E. Petterson; A. Bruchfeld; K. W.A. Westman; Z. Heigl; C. Chizzolini; D. MacLahan; M. Depierreux; B. van Damme; A. Stejskalova; Z. Vernerova; T. Tornroth; A. C. Feller; E. Gaffney; R. Tardanico; R. Consalonieri; G. Garibotto; A. T.M.G. Tiebosch; C. D. Kooijman; M. S. Arques; F. Algaba; M. Carreras; M. Vaquero Perez; L. Bernardo; B. Sundelin; P. Alm; A. Wernersson; B. Veress; W. Landells; A. J. Howie; S. Fleming; A. P. Griffith; P. N. Furness; H. T. Cook

doi:10.1046/j.1523-1755.2002.00605.x

Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients

Herbert A. Hauer, Ingeborg M. Bajema, Hans C. Van Houwelingen, Franco Ferrario, Laure Hélène Noël, R. Waldherr, David R.W. Jayne, N. Rasmussen, Jan A. Bruijn, E. Christiaan Hagen, N. Rasmussen, D. R.W. Jayne, I. Neumann, P. Mad-Houn, J. Sennesael, V. Tesar, I. Rychlik, J. Bartunkova, J. Luk, B. Ravn JuhlJ. Petersen, C. B. Andersen, W. Szpirt, A. Wiik, H. Lokkegaard, H. Nielsen, T. Ring, S. Freiesleben Sorensen, P. A. Bacon, A. Exley, C. O.S. Savage, G. Gaskin, C. Pusey, C. M. Lockwood, R. Luq-Mani, C. Gronhagen-Riska, A. Ekstrand, L. Guillevin, F. Lhote, P. Lesavre, L. H. Noel, P. Landais, P. Vanhille, P. Bataille, V. Esnault, F. Van Der Woude, R. Waldherr, W. Schmitt, K. Andrassy, O. Hergesell, R. Nowack, K. De Groot, K. Herlyn, W. L. Gross, K. A. Boki, J. N. Boletis, D. S. Emmanouel, C. Feighery, Y. Ferra-Rio, R. A. Sinico, G. Gregorini, J. Dadoniene, E. C. Hagen, C. G.M. Kallenberg, C. Stegeman, J. W.Cohen Tervaert, C. A. Verburgh, C. E.H. Siegert, J. A. Bruijn, H. A. Hauer, J. Hermans, J. C.Van Houwelingen, C. E. Vergunst, E. Van Gurp, I. M. Bajema, C. Vasconcelos, E. Mirapeix, M. Sole, E. E. Petterson, A. Bruchfeld, K. W.A. Westman, Z. Heigl, C. Chizzolini, D. MacLahan, M. Depierreux, B. van Damme, A. Stejskalova, Z. Vernerova, T. Tornroth, A. C. Feller, E. Gaffney, R. Tardanico, R. Consalonieri, G. Garibotto, A. T.M.G. Tiebosch, C. D. Kooijman, M. S. Arques, F. Algaba, M. Carreras, M. Vaquero Perez, L. Bernardo, B. Sundelin, P. Alm, A. Wernersson, B. Veress, W. Landells, A. J. Howie, S. Fleming, A. P. Griffith, P. N. Furness, H. T. Cook

157 Citations (Scopus)

Abstract

Background. The predictive value of clinical and renal histological features for renal outcome in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis was investigated in a prospective analysis of 96 patients with ANCA-associated vasculitis, and moderate renal involvement (creatinine <500 μmol/L). Methods. The extent of 39 histological features in 96 biopsies (performed at entry in a clinical trial) was scored by two independent observers, according to a standardized protocol. Age, gender, diagnosis, glomerular filtration rate at entry (GFR₀), ANCA-specificity, proteinuria, and treatment of these 96 patients were also taken into account. Treatment was standardized and started after the biopsy was performed. Endpoints included renal function at 18 months (GFR₁₈), GFR₁₈ corrected for GFR₀ (CORGFR₁₈), and the occurrence of relapse or death. Results. Parameters that most strongly correlated with GFR₁₈ were GFR₀ (r = 0.67), interstitial fibrosis (r = -0.45), glomerulosclerosis (r = -0.37), and tubular atrophy (r = -0.36). Parameters that most strongly correlated with CORGFR₁₈ were segmental (r = 0.45) and cellular (r = 0.30) crescents, and fibrinoid necrosis (r = 0.46). None of the clinical and histological features predicted the occurrence of relapse or death. By applying a stepwise linear multiple regression analysis, we designed a formula for the estimation of renal function at 18 months: GFR₁₈ (mL/min) = 17 + 0.71 × GFR₀ (mL/min) + 0.34 × fibrinoid necrosis (%) + 0.33 × segmental crescents (%), (r² = 0.60; standard deviation = 19 mL/min). Our results were independent of diagnosis, ANCA-specificity, and treatment limb. Conclusions. These data suggest that in ANCA-associated glomerulonephritis, GFR₀ and predominantly chronic renal lesions are potent predictors of GFR₁₈. Active lesions are associated with renal function recovery and may be reversible. The formula for the estimation of GFR₁₈ shows that a combination of GFR₀ and renal histology is a better predictor for GFR₁₈ than GFR₀ only.

Original language	English
Journal	Kidney International
Volume	62
Issue number	5
Pages (from-to)	1732-1742
Number of pages	11
ISSN	0085-2538
DOIs	https://doi.org/10.1046/j.1523-1755.2002.00605.x
Publication status	Published - 2002

Research Areas and Centers

Academic Focus: Center for Infection and Inflammation Research (ZIEL)

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1046/j.1523-1755.2002.00605.x

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Hauer, H. A., Bajema, I. M., Van Houwelingen, H. C., Ferrario, F., Noël, L. H., Waldherr, R., Jayne, D. R. W., Rasmussen, N., Bruijn, J. A., Hagen, E. C., Rasmussen, N., Jayne, D. R. W., Neumann, I., Mad-Houn, P., Sennesael, J., Tesar, V., Rychlik, I., Bartunkova, J., Luk, J., ... Cook, H. T. (2002). Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients. Kidney International, 62(5), 1732-1742. https://doi.org/10.1046/j.1523-1755.2002.00605.x

@article{39049453ad8440ddb7ad5ac729251984,

title = "Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients",

abstract = "Background. The predictive value of clinical and renal histological features for renal outcome in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis was investigated in a prospective analysis of 96 patients with ANCA-associated vasculitis, and moderate renal involvement (creatinine <500 μmol/L). Methods. The extent of 39 histological features in 96 biopsies (performed at entry in a clinical trial) was scored by two independent observers, according to a standardized protocol. Age, gender, diagnosis, glomerular filtration rate at entry (GFR0), ANCA-specificity, proteinuria, and treatment of these 96 patients were also taken into account. Treatment was standardized and started after the biopsy was performed. Endpoints included renal function at 18 months (GFR18), GFR18 corrected for GFR0 (CORGFR18), and the occurrence of relapse or death. Results. Parameters that most strongly correlated with GFR18 were GFR0 (r = 0.67), interstitial fibrosis (r = -0.45), glomerulosclerosis (r = -0.37), and tubular atrophy (r = -0.36). Parameters that most strongly correlated with CORGFR18 were segmental (r = 0.45) and cellular (r = 0.30) crescents, and fibrinoid necrosis (r = 0.46). None of the clinical and histological features predicted the occurrence of relapse or death. By applying a stepwise linear multiple regression analysis, we designed a formula for the estimation of renal function at 18 months: GFR18 (mL/min) = 17 + 0.71 × GFR0 (mL/min) + 0.34 × fibrinoid necrosis (%) + 0.33 × segmental crescents (%), (r2 = 0.60; standard deviation = 19 mL/min). Our results were independent of diagnosis, ANCA-specificity, and treatment limb. Conclusions. These data suggest that in ANCA-associated glomerulonephritis, GFR0 and predominantly chronic renal lesions are potent predictors of GFR18. Active lesions are associated with renal function recovery and may be reversible. The formula for the estimation of GFR18 shows that a combination of GFR0 and renal histology is a better predictor for GFR18 than GFR0 only.",

author = "Hauer, {Herbert A.} and Bajema, {Ingeborg M.} and {Van Houwelingen}, {Hans C.} and Franco Ferrario and No{\"e}l, {Laure H{\'e}l{\`e}ne} and R. Waldherr and Jayne, {David R.W.} and N. Rasmussen and Bruijn, {Jan A.} and Hagen, {E. Christiaan} and N. Rasmussen and Jayne, {D. R.W.} and I. Neumann and P. Mad-Houn and J. Sennesael and V. Tesar and I. Rychlik and J. Bartunkova and J. Luk and Juhl, {B. Ravn} and J. Petersen and Andersen, {C. B.} and W. Szpirt and A. Wiik and H. Lokkegaard and H. Nielsen and T. Ring and Sorensen, {S. Freiesleben} and Bacon, {P. A.} and A. Exley and Savage, {C. O.S.} and G. Gaskin and C. Pusey and Lockwood, {C. M.} and R. Luq-Mani and C. Gronhagen-Riska and A. Ekstrand and L. Guillevin and F. Lhote and P. Lesavre and Noel, {L. H.} and P. Landais and P. Vanhille and P. Bataille and V. Esnault and Woude, {F. Van Der} and R. Waldherr and W. Schmitt and K. Andrassy and O. Hergesell and R. Nowack and Groot, {K. De} and K. Herlyn and Gross, {W. L.} and Boki, {K. A.} and Boletis, {J. N.} and Emmanouel, {D. S.} and C. Feighery and Y. Ferra-Rio and Sinico, {R. A.} and G. Gregorini and J. Dadoniene and Hagen, {E. C.} and Kallenberg, {C. G.M.} and C. Stegeman and Tervaert, {J. W.Cohen} and Verburgh, {C. A.} and Siegert, {C. E.H.} and Bruijn, {J. A.} and Hauer, {H. A.} and J. Hermans and Houwelingen, {J. C.Van} and Vergunst, {C. E.} and Gurp, {E. Van} and Bajema, {I. M.} and C. Vasconcelos and E. Mirapeix and M. Sole and Petterson, {E. E.} and A. Bruchfeld and Westman, {K. W.A.} and Z. Heigl and C. Chizzolini and D. MacLahan and M. Depierreux and {van Damme}, B. and A. Stejskalova and Z. Vernerova and T. Tornroth and Feller, {A. C.} and E. Gaffney and R. Tardanico and R. Consalonieri and G. Garibotto and Tiebosch, {A. T.M.G.} and Kooijman, {C. D.} and Arques, {M. S.} and F. Algaba and M. Carreras and Perez, {M. Vaquero} and L. Bernardo and B. Sundelin and P. Alm and A. Wernersson and B. Veress and W. Landells and Howie, {A. J.} and S. Fleming and Griffith, {A. P.} and Furness, {P. N.} and Cook, {H. T.}",

year = "2002",

doi = "10.1046/j.1523-1755.2002.00605.x",

language = "English",

volume = "62",

pages = "1732--1742",

journal = "Kidney International",

issn = "0085-2538",

number = "5",

}

Hauer, HA, Bajema, IM, Van Houwelingen, HC, Ferrario, F, Noël, LH, Waldherr, R, Jayne, DRW, Rasmussen, N, Bruijn, JA, Hagen, EC, Rasmussen, N, Jayne, DRW, Neumann, I, Mad-Houn, P, Sennesael, J, Tesar, V, Rychlik, I, Bartunkova, J, Luk, J, Juhl, BR, Petersen, J, Andersen, CB, Szpirt, W, Wiik, A, Lokkegaard, H, Nielsen, H, Ring, T, Sorensen, SF, Bacon, PA, Exley, A, Savage, COS, Gaskin, G, Pusey, C, Lockwood, CM, Luq-Mani, R, Gronhagen-Riska, C, Ekstrand, A, Guillevin, L, Lhote, F, Lesavre, P, Noel, LH, Landais, P, Vanhille, P, Bataille, P, Esnault, V, Woude, FVD, Waldherr, R, Schmitt, W, Andrassy, K, Hergesell, O, Nowack, R, Groot, KD, Herlyn, K, Gross, WL, Boki, KA, Boletis, JN, Emmanouel, DS, Feighery, C, Ferra-Rio, Y, Sinico, RA, Gregorini, G, Dadoniene, J, Hagen, EC, Kallenberg, CGM, Stegeman, C, Tervaert, JWC, Verburgh, CA, Siegert, CEH, Bruijn, JA, Hauer, HA, Hermans, J, Houwelingen, JCV, Vergunst, CE, Gurp, EV, Bajema, IM, Vasconcelos, C, Mirapeix, E, Sole, M, Petterson, EE, Bruchfeld, A, Westman, KWA, Heigl, Z, Chizzolini, C, MacLahan, D, Depierreux, M, van Damme, B, Stejskalova, A, Vernerova, Z, Tornroth, T, Feller, AC, Gaffney, E, Tardanico, R, Consalonieri, R, Garibotto, G, Tiebosch, ATMG, Kooijman, CD, Arques, MS, Algaba, F, Carreras, M, Perez, MV, Bernardo, L, Sundelin, B, Alm, P, Wernersson, A, Veress, B, Landells, W, Howie, AJ, Fleming, S, Griffith, AP, Furness, PN & Cook, HT 2002, 'Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients', Kidney International, vol. 62, no. 5, pp. 1732-1742. https://doi.org/10.1046/j.1523-1755.2002.00605.x

Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients. / Hauer, Herbert A.; Bajema, Ingeborg M.; Van Houwelingen, Hans C. et al.
In: Kidney International, Vol. 62, No. 5, 2002, p. 1732-1742.

Research output: Journal Articles › Journal articles › Research › peer-review

TY - JOUR

T1 - Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients

AU - Hauer, Herbert A.

AU - Bajema, Ingeborg M.

AU - Van Houwelingen, Hans C.

AU - Ferrario, Franco

AU - Noël, Laure Hélène

AU - Waldherr, R.

AU - Jayne, David R.W.

AU - Rasmussen, N.

AU - Bruijn, Jan A.

AU - Hagen, E. Christiaan

AU - Rasmussen, N.

AU - Jayne, D. R.W.

AU - Neumann, I.

AU - Mad-Houn, P.

AU - Sennesael, J.

AU - Tesar, V.

AU - Rychlik, I.

AU - Bartunkova, J.

AU - Luk, J.

AU - Juhl, B. Ravn

AU - Petersen, J.

AU - Andersen, C. B.

AU - Szpirt, W.

AU - Wiik, A.

AU - Lokkegaard, H.

AU - Nielsen, H.

AU - Ring, T.

AU - Sorensen, S. Freiesleben

AU - Bacon, P. A.

AU - Exley, A.

AU - Savage, C. O.S.

AU - Gaskin, G.

AU - Pusey, C.

AU - Lockwood, C. M.

AU - Luq-Mani, R.

AU - Gronhagen-Riska, C.

AU - Ekstrand, A.

AU - Guillevin, L.

AU - Lhote, F.

AU - Lesavre, P.

AU - Noel, L. H.

AU - Landais, P.

AU - Vanhille, P.

AU - Bataille, P.

AU - Esnault, V.

AU - Woude, F. Van Der

AU - Waldherr, R.

AU - Schmitt, W.

AU - Andrassy, K.

AU - Hergesell, O.

AU - Nowack, R.

AU - Groot, K. De

AU - Herlyn, K.

AU - Gross, W. L.

AU - Boki, K. A.

AU - Boletis, J. N.

AU - Emmanouel, D. S.

AU - Feighery, C.

AU - Ferra-Rio, Y.

AU - Sinico, R. A.

AU - Gregorini, G.

AU - Dadoniene, J.

AU - Hagen, E. C.

AU - Kallenberg, C. G.M.

AU - Stegeman, C.

AU - Tervaert, J. W.Cohen

AU - Verburgh, C. A.

AU - Siegert, C. E.H.

AU - Bruijn, J. A.

AU - Hauer, H. A.

AU - Hermans, J.

AU - Houwelingen, J. C.Van

AU - Vergunst, C. E.

AU - Gurp, E. Van

AU - Bajema, I. M.

AU - Vasconcelos, C.

AU - Mirapeix, E.

AU - Sole, M.

AU - Petterson, E. E.

AU - Bruchfeld, A.

AU - Westman, K. W.A.

AU - Heigl, Z.

AU - Chizzolini, C.

AU - MacLahan, D.

AU - Depierreux, M.

AU - van Damme, B.

AU - Stejskalova, A.

AU - Vernerova, Z.

AU - Tornroth, T.

AU - Feller, A. C.

AU - Gaffney, E.

AU - Tardanico, R.

AU - Consalonieri, R.

AU - Garibotto, G.

AU - Tiebosch, A. T.M.G.

AU - Kooijman, C. D.

AU - Arques, M. S.

AU - Algaba, F.

AU - Carreras, M.

AU - Perez, M. Vaquero

AU - Bernardo, L.

AU - Sundelin, B.

AU - Alm, P.

AU - Wernersson, A.

AU - Veress, B.

AU - Landells, W.

AU - Howie, A. J.

AU - Fleming, S.

AU - Griffith, A. P.

AU - Furness, P. N.

AU - Cook, H. T.

PY - 2002

Y1 - 2002

N2 - Background. The predictive value of clinical and renal histological features for renal outcome in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis was investigated in a prospective analysis of 96 patients with ANCA-associated vasculitis, and moderate renal involvement (creatinine <500 μmol/L). Methods. The extent of 39 histological features in 96 biopsies (performed at entry in a clinical trial) was scored by two independent observers, according to a standardized protocol. Age, gender, diagnosis, glomerular filtration rate at entry (GFR0), ANCA-specificity, proteinuria, and treatment of these 96 patients were also taken into account. Treatment was standardized and started after the biopsy was performed. Endpoints included renal function at 18 months (GFR18), GFR18 corrected for GFR0 (CORGFR18), and the occurrence of relapse or death. Results. Parameters that most strongly correlated with GFR18 were GFR0 (r = 0.67), interstitial fibrosis (r = -0.45), glomerulosclerosis (r = -0.37), and tubular atrophy (r = -0.36). Parameters that most strongly correlated with CORGFR18 were segmental (r = 0.45) and cellular (r = 0.30) crescents, and fibrinoid necrosis (r = 0.46). None of the clinical and histological features predicted the occurrence of relapse or death. By applying a stepwise linear multiple regression analysis, we designed a formula for the estimation of renal function at 18 months: GFR18 (mL/min) = 17 + 0.71 × GFR0 (mL/min) + 0.34 × fibrinoid necrosis (%) + 0.33 × segmental crescents (%), (r2 = 0.60; standard deviation = 19 mL/min). Our results were independent of diagnosis, ANCA-specificity, and treatment limb. Conclusions. These data suggest that in ANCA-associated glomerulonephritis, GFR0 and predominantly chronic renal lesions are potent predictors of GFR18. Active lesions are associated with renal function recovery and may be reversible. The formula for the estimation of GFR18 shows that a combination of GFR0 and renal histology is a better predictor for GFR18 than GFR0 only.

AB - Background. The predictive value of clinical and renal histological features for renal outcome in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis was investigated in a prospective analysis of 96 patients with ANCA-associated vasculitis, and moderate renal involvement (creatinine <500 μmol/L). Methods. The extent of 39 histological features in 96 biopsies (performed at entry in a clinical trial) was scored by two independent observers, according to a standardized protocol. Age, gender, diagnosis, glomerular filtration rate at entry (GFR0), ANCA-specificity, proteinuria, and treatment of these 96 patients were also taken into account. Treatment was standardized and started after the biopsy was performed. Endpoints included renal function at 18 months (GFR18), GFR18 corrected for GFR0 (CORGFR18), and the occurrence of relapse or death. Results. Parameters that most strongly correlated with GFR18 were GFR0 (r = 0.67), interstitial fibrosis (r = -0.45), glomerulosclerosis (r = -0.37), and tubular atrophy (r = -0.36). Parameters that most strongly correlated with CORGFR18 were segmental (r = 0.45) and cellular (r = 0.30) crescents, and fibrinoid necrosis (r = 0.46). None of the clinical and histological features predicted the occurrence of relapse or death. By applying a stepwise linear multiple regression analysis, we designed a formula for the estimation of renal function at 18 months: GFR18 (mL/min) = 17 + 0.71 × GFR0 (mL/min) + 0.34 × fibrinoid necrosis (%) + 0.33 × segmental crescents (%), (r2 = 0.60; standard deviation = 19 mL/min). Our results were independent of diagnosis, ANCA-specificity, and treatment limb. Conclusions. These data suggest that in ANCA-associated glomerulonephritis, GFR0 and predominantly chronic renal lesions are potent predictors of GFR18. Active lesions are associated with renal function recovery and may be reversible. The formula for the estimation of GFR18 shows that a combination of GFR0 and renal histology is a better predictor for GFR18 than GFR0 only.

UR - http://www.scopus.com/inward/record.url?scp=18644382821&partnerID=8YFLogxK

U2 - 10.1046/j.1523-1755.2002.00605.x

DO - 10.1046/j.1523-1755.2002.00605.x

M3 - Journal articles

C2 - 12371974

AN - SCOPUS:18644382821

SN - 0085-2538

VL - 62

SP - 1732

EP - 1742

JO - Kidney International

JF - Kidney International

IS - 5

ER -

Clinical nephrology-epidemiology-clinical trials: Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients

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