{Reference Type}: Journal Article
{Title}: Histopathological classification of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis in a nationwide Japanese prospective 2-year follow-up cohort study.
{Author}: Yamagata K;Usui J;Nagata M;Sugiyama H;Sada KE;Muso E;Harigai M;Amano K;Atsumi T;Fujimoto S;Yuzawa Y;Kobayashi M;Saito T;Ito T;Hirawa N;Homma S;Dobashi H;Tsuboi N;Ishizu A;Arimura Y;Makino H;Matsuo S; ;
{Journal}: Clin Exp Nephrol
{Volume}: 23
{Issue}: 3
{Year}: Mar 2019
{Factor}: 2.617
{DOI}: 10.1007/s10157-018-1656-1
{Abstract}: <B>BACKGROUND: </B>The prognostic value of the EUVAS-proposed histopathological classification of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis has been evaluated throughout the world. Here, we performed a Japanese nationwide biopsy survey to assess the association between this histopathological classification and renal prognosis after 2-year follow-up in ANCA-associated glomerulonephritis.<BR><B>METHODS: </B>We collected 67 renal biopsy materials of the 321 entries in the RemIT-JAV-RPGN cohort study, and assessed their histologies. Based on the EUVAS-proposed histopathological classification and some histological parameters, we statistically evaluated renal survival and the comparison of renal function for 2 years.<BR><B>RESULTS: </B>Based on the histopathological classification, the largest number of biopsy samples belonged to the Focal class, followed by the Mixed, Crescentic, and Sclerotic classes (n = 30, 19, 10, 8, respectively). Although the number of events might be too low (four patients with renal death) to make this conclusion, the Focal and Mixed classes had higher renal-survival rates compared to the others in the renal-survival curve. Comparing renal function among all classes, the estimated glomerular filtration rate (eGFR) throughout 2-year follow-up period was significantly higher in the Focal class compared to the other 3 classes. The eGFR-values in the Crescentic, Mixed, and Sclerotic classes increased with time. Based on both combined results, the Focal class could be the best prognosis.<BR><B>CONCLUSIONS: </B>This histopathological classification was valuable for both the stratification of renal function and the estimation of partial renal survival during 2-year follow-up in ANCA-associated glomerulonephritis.