Comparative analysis of renal decline rates in microscopic polyangiitis: unveiling the slowly progressive phenotype.

IF 2.7 Q3 IMMUNOLOGY
Kanako Tsutsumi, Narumichi Iwamura, Katsumi Eguchi, Ayuko Takatani, Tomohiro Koga, Takeshi Araki, Toshiyuki Aramaki, Kaoru Terada, Yukitaka Ueki
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Abstract

Although rapidly progressive glomerulonephritis (RPGN) is the main renal phenotype of microscopic polyangiitis (MPA), we aim to clarify the clinical features of slowly progressive MPA. This retrospective observational study included 12 patients diagnosed with MPA in our hospital between January 2012 and February 2022. We investigated the differences in surrogate markers, rate of decline of estimated glomerular filtration rate (eGFR) between the slowly progressive and rapidly progressive MPA groups. Of the 12 patients with MPA, 3 (25.0%) had slowly progressive MPA: MPA within 30% decrease in eGFR 3 months pretreatment, all of whom developed RPGN during the course. Patients with slowly progressive MPA had lower levels of C-reactive protein, myeloperoxidase anti-neutrophil cytoplasmic antibodies, and interleukin-6; higher levels of sialylated carbohydrate antigen KL-6. Slowly progressive MPA is not uncommon in our hospital. A linear relationship was found between slower rate of eGFR decline and lower surrogate markers of disease activity. Some MPA cases have slowly progressive glomerulonephritis leading to RPGN, which may be clinically characterized by low disease activity. It may be useful to measure myeloperoxidase anti-neutrophil cytoplasmic antibody in chronic kidney disease with concomitant urinary abnormalities to diagnose MPA with slowly progressive glomerulonephritis.

显微镜下多血管炎肾衰率的比较分析:揭示缓慢进展的表型。
虽然快速进展性肾小球肾炎(RPGN)是显微镜下多血管炎(MPA)的主要肾脏表型,但我们的目的是阐明缓慢进展性MPA的临床特征。这项回顾性观察研究纳入了我院2012年1月至2022年2月期间确诊的12例MPA患者。我们研究了缓慢进展组和快速进展组MPA患者在代用指标、估计肾小球滤过率(eGFR)下降率方面的差异。在 12 例 MPA 患者中,3 例(25.0%)为缓慢进展型 MPA:在治疗前 3 个月,MPA 患者的 eGFR 下降了 30%,他们在治疗过程中都出现了 RPGN。缓慢进展型 MPA 患者的 C 反应蛋白、髓过氧化物酶抗中性粒细胞胞浆抗体和白细胞介素-6 水平较低;硅氨酰化碳水化合物抗原 KL-6 水平较高。缓慢进展的 MPA 在我院并不少见。研究发现,eGFR下降速度较慢与疾病活动性替代指标较低之间存在线性关系。有些 MPA 病例的肾小球肾炎进展缓慢,最终导致 RPGN,其临床特征可能是疾病活动性较低。在慢性肾脏病伴有泌尿系统异常时,测量髓过氧化物酶抗中性粒细胞胞浆抗体可能有助于诊断伴有缓慢进展性肾小球肾炎的 MPA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Immunological Medicine
Immunological Medicine Medicine-Immunology and Allergy
CiteScore
7.10
自引率
2.30%
发文量
19
审稿时长
19 weeks
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