Kidney Outcomes in ANCA-Glomerulonephritis According to Induction Immunosuppression and Histopathology.
In crescentic-class ANCA-GN, rituximab monotherapy had lower odds of eGFR recovery than cyclophosphamide (OR 0.23) and a higher risk of kidney failure (HR 3.42); no differences were seen in other Berden classes.
Study design
Retrospective multicenter study of 304 patients with biopsy-proven ANCA-glomerulonephritis grouped by Berden class; median baseline eGFR 20 ml/min per 1.73 m2. Induction was cyclophosphamide (59%), rituximab (17%) or both (24%).
Key findings
Overall, 50% recovered kidney function and 19.4% reached kidney failure over a median 42 months. In the crescentic class, rituximab alone was associated with lower eGFR recovery than cyclophosphamide (OR 0.23, 95% CI 0.05-0.98) and higher kidney failure risk (HR 3.42, 95% CI 1.03-11.35).
Clinical implications
Kidney biopsy class may help personalise induction; cyclophosphamide-based regimens may be preferable in crescentic ANCA-GN pending prospective validation.
Category
Research
Source
Kidney International Reports
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.