Efficacy of the fibrosis index for predicting end‐stage renal disease in patients with antineutrophil cytoplasmic antibody‐associated vasculitis
Objective Kidney involvement is a major manifestation of antineutrophil cytoplasmic antibody‐associated vasculitis (AAV) and may progress to end‐stage renal disease (ESRD), requiring renal replacement therapy. Unfortunately, there is no reliable kidney‐specific index for predicting the progression o...
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| Veröffentlicht in: | International journal of clinical practice (Esher) 2021-04, Vol.75 (4), p.e13929-n/a |
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| creator | Pyo, Jung Yoon Ahn, Sung Soo Lee, Lucy Eunju Choe, Ha Na Song, Jason Jungsik Park, Yong‐Beom Lee, Sang‐Won |
| description | Objective
Kidney involvement is a major manifestation of antineutrophil cytoplasmic antibody‐associated vasculitis (AAV) and may progress to end‐stage renal disease (ESRD), requiring renal replacement therapy. Unfortunately, there is no reliable kidney‐specific index for predicting the progression of renal disease to ESRD. The fibrosis index (FI) reflects the degree of fibrosis in chronic liver disease. This study aimed to investigate whether the FI at the time of diagnosis could predict the development of ESRD in AAV patients.
Methods
We retrospectively reviewed the medical records of 211 immunosuppressive drug‐naïve AAV patients and extrapolated the cut‐off FI value for predicting the development of ESRD using receiver operating characteristic curves. The associations between the FI and clinical outcomes, including mortality, relapse, and ESRD development, were determined.
Results
Overall, 39 (18.5%) patients developed ESRD owing to the progression of AAV‐associated renal disease. The median FI was higher in AAV patients with ESRD than in those without (1.61 vs 1.04; P = .001). The FI cut‐off was 1.72. The incidence of ESRD was higher in patients with FI ≥ 1.72 at the time of diagnosis than in those with an FI |
| doi_str_mv | 10.1111/ijcp.13929 |
| format | Article |
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Kidney involvement is a major manifestation of antineutrophil cytoplasmic antibody‐associated vasculitis (AAV) and may progress to end‐stage renal disease (ESRD), requiring renal replacement therapy. Unfortunately, there is no reliable kidney‐specific index for predicting the progression of renal disease to ESRD. The fibrosis index (FI) reflects the degree of fibrosis in chronic liver disease. This study aimed to investigate whether the FI at the time of diagnosis could predict the development of ESRD in AAV patients.
Methods
We retrospectively reviewed the medical records of 211 immunosuppressive drug‐naïve AAV patients and extrapolated the cut‐off FI value for predicting the development of ESRD using receiver operating characteristic curves. The associations between the FI and clinical outcomes, including mortality, relapse, and ESRD development, were determined.
Results
Overall, 39 (18.5%) patients developed ESRD owing to the progression of AAV‐associated renal disease. The median FI was higher in AAV patients with ESRD than in those without (1.61 vs 1.04; P = .001). The FI cut‐off was 1.72. The incidence of ESRD was higher in patients with FI ≥ 1.72 at the time of diagnosis than in those with an FI < 1.72 at the time of diagnosis (relative risk: 4.655; 95% confidence interval: 2.242‐9.662; P < .001). Kaplan‐Meier survival analysis revealed that patients with an FI ≥ 1.72 at the time of diagnosis exhibited significantly lower ESRD‐free survival rates than those with an FI < 1.72 at the time of diagnosis (P < .001).
Conclusion
FI ≥ 1.72 at the time of diagnosis may be an independent predictive marker for ESRD in AAV patients.</description><identifier>ISSN: 1368-5031</identifier><identifier>EISSN: 1742-1241</identifier><identifier>DOI: 10.1111/ijcp.13929</identifier><identifier>PMID: 33301633</identifier><language>eng</language><publisher>England: Hindawi Limited</publisher><subject>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications ; Antibodies, Antineutrophil Cytoplasmic ; Antineutrophil cytoplasmic antibodies ; Diagnosis ; Fibrosis ; Humans ; Immunosuppressive agents ; Kidney diseases ; Kidney Failure, Chronic - etiology ; Kidneys ; Liver diseases ; Medical records ; Patients ; Retrospective Studies ; Survival ; Survival analysis ; Vasculitis</subject><ispartof>International journal of clinical practice (Esher), 2021-04, Vol.75 (4), p.e13929-n/a</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3939-461622745048cfe30ade0c1371927bb6a142dea3531ce751de3a52d04d5bb4ae3</citedby><cites>FETCH-LOGICAL-c3939-461622745048cfe30ade0c1371927bb6a142dea3531ce751de3a52d04d5bb4ae3</cites><orcidid>0000-0001-9446-1892 ; 0000-0002-1866-6885 ; 0000-0002-0897-661X ; 0000-0003-0662-7704 ; 0000-0002-8038-3341 ; 0000-0002-9002-9880 ; 0000-0003-4695-8620</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fijcp.13929$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fijcp.13929$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33301633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pyo, Jung Yoon</creatorcontrib><creatorcontrib>Ahn, Sung Soo</creatorcontrib><creatorcontrib>Lee, Lucy Eunju</creatorcontrib><creatorcontrib>Choe, Ha Na</creatorcontrib><creatorcontrib>Song, Jason Jungsik</creatorcontrib><creatorcontrib>Park, Yong‐Beom</creatorcontrib><creatorcontrib>Lee, Sang‐Won</creatorcontrib><title>Efficacy of the fibrosis index for predicting end‐stage renal disease in patients with antineutrophil cytoplasmic antibody‐associated vasculitis</title><title>International journal of clinical practice (Esher)</title><addtitle>Int J Clin Pract</addtitle><description>Objective
Kidney involvement is a major manifestation of antineutrophil cytoplasmic antibody‐associated vasculitis (AAV) and may progress to end‐stage renal disease (ESRD), requiring renal replacement therapy. Unfortunately, there is no reliable kidney‐specific index for predicting the progression of renal disease to ESRD. The fibrosis index (FI) reflects the degree of fibrosis in chronic liver disease. This study aimed to investigate whether the FI at the time of diagnosis could predict the development of ESRD in AAV patients.
Methods
We retrospectively reviewed the medical records of 211 immunosuppressive drug‐naïve AAV patients and extrapolated the cut‐off FI value for predicting the development of ESRD using receiver operating characteristic curves. The associations between the FI and clinical outcomes, including mortality, relapse, and ESRD development, were determined.
Results
Overall, 39 (18.5%) patients developed ESRD owing to the progression of AAV‐associated renal disease. The median FI was higher in AAV patients with ESRD than in those without (1.61 vs 1.04; P = .001). The FI cut‐off was 1.72. The incidence of ESRD was higher in patients with FI ≥ 1.72 at the time of diagnosis than in those with an FI < 1.72 at the time of diagnosis (relative risk: 4.655; 95% confidence interval: 2.242‐9.662; P < .001). Kaplan‐Meier survival analysis revealed that patients with an FI ≥ 1.72 at the time of diagnosis exhibited significantly lower ESRD‐free survival rates than those with an FI < 1.72 at the time of diagnosis (P < .001).
Conclusion
FI ≥ 1.72 at the time of diagnosis may be an independent predictive marker for ESRD in AAV patients.</description><subject>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications</subject><subject>Antibodies, Antineutrophil Cytoplasmic</subject><subject>Antineutrophil cytoplasmic antibodies</subject><subject>Diagnosis</subject><subject>Fibrosis</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Kidneys</subject><subject>Liver diseases</subject><subject>Medical records</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Vasculitis</subject><issn>1368-5031</issn><issn>1742-1241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90b-O1DAQBvAIgbjjoOEBkCUahJTD9tj5U6LVAYdOggLqyLEnt7PKxsF2ONLxCBQ8IU-C9_agoMCNLc3PXzFfUTwV_Fzk84p2dj4X0Mr2XnEqaiVLIZW4n99QNaXmIE6KRzHuOJdaN_xhcQIAXFQAp8XPi2Ega-zK_MDSFtlAffCRIqPJ4Tc2-MDmgI5souma4eR-ff8Rk7lGFnAyI3MU0UTMnM0mEU4pshtKW2am_AOXFPy8pZHZNfl5NHFP9nbUe7fmKBOjt2QSOvbVRLuMlCg-Lh4MZoz45O4-Kz6_ufi0eVdefXh7uXl9VVpooS1VJSopa6W5auyAwI1DbgXUopV131dGKOnQgAZhsdbCIRgtHVdO970yCGfFi2PuHPyXBWPq9hQtjqOZ0C-xk6oWGholm0yf_0N3fgl5AVlp3kqAtj6ol0dl8w5jwKGbA-1NWDvBu0NX3aGr7rarjJ_dRS79Ht1f-qecDMQR3NCI63-iusv3m4_H0N97KaPC</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Pyo, Jung Yoon</creator><creator>Ahn, Sung Soo</creator><creator>Lee, Lucy Eunju</creator><creator>Choe, Ha Na</creator><creator>Song, Jason Jungsik</creator><creator>Park, Yong‐Beom</creator><creator>Lee, Sang‐Won</creator><general>Hindawi Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9446-1892</orcidid><orcidid>https://orcid.org/0000-0002-1866-6885</orcidid><orcidid>https://orcid.org/0000-0002-0897-661X</orcidid><orcidid>https://orcid.org/0000-0003-0662-7704</orcidid><orcidid>https://orcid.org/0000-0002-8038-3341</orcidid><orcidid>https://orcid.org/0000-0002-9002-9880</orcidid><orcidid>https://orcid.org/0000-0003-4695-8620</orcidid></search><sort><creationdate>202104</creationdate><title>Efficacy of the fibrosis index for predicting end‐stage renal disease in patients with antineutrophil cytoplasmic antibody‐associated vasculitis</title><author>Pyo, Jung Yoon ; Ahn, Sung Soo ; Lee, Lucy Eunju ; Choe, Ha Na ; Song, Jason Jungsik ; Park, Yong‐Beom ; Lee, Sang‐Won</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3939-461622745048cfe30ade0c1371927bb6a142dea3531ce751de3a52d04d5bb4ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications</topic><topic>Antibodies, Antineutrophil Cytoplasmic</topic><topic>Antineutrophil cytoplasmic antibodies</topic><topic>Diagnosis</topic><topic>Fibrosis</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Kidneys</topic><topic>Liver diseases</topic><topic>Medical records</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Vasculitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pyo, Jung Yoon</creatorcontrib><creatorcontrib>Ahn, Sung Soo</creatorcontrib><creatorcontrib>Lee, Lucy Eunju</creatorcontrib><creatorcontrib>Choe, Ha Na</creatorcontrib><creatorcontrib>Song, Jason Jungsik</creatorcontrib><creatorcontrib>Park, Yong‐Beom</creatorcontrib><creatorcontrib>Lee, Sang‐Won</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical practice (Esher)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pyo, Jung Yoon</au><au>Ahn, Sung Soo</au><au>Lee, Lucy Eunju</au><au>Choe, Ha Na</au><au>Song, Jason Jungsik</au><au>Park, Yong‐Beom</au><au>Lee, Sang‐Won</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of the fibrosis index for predicting end‐stage renal disease in patients with antineutrophil cytoplasmic antibody‐associated vasculitis</atitle><jtitle>International journal of clinical practice (Esher)</jtitle><addtitle>Int J Clin Pract</addtitle><date>2021-04</date><risdate>2021</risdate><volume>75</volume><issue>4</issue><spage>e13929</spage><epage>n/a</epage><pages>e13929-n/a</pages><issn>1368-5031</issn><eissn>1742-1241</eissn><abstract>Objective
Kidney involvement is a major manifestation of antineutrophil cytoplasmic antibody‐associated vasculitis (AAV) and may progress to end‐stage renal disease (ESRD), requiring renal replacement therapy. Unfortunately, there is no reliable kidney‐specific index for predicting the progression of renal disease to ESRD. The fibrosis index (FI) reflects the degree of fibrosis in chronic liver disease. This study aimed to investigate whether the FI at the time of diagnosis could predict the development of ESRD in AAV patients.
Methods
We retrospectively reviewed the medical records of 211 immunosuppressive drug‐naïve AAV patients and extrapolated the cut‐off FI value for predicting the development of ESRD using receiver operating characteristic curves. The associations between the FI and clinical outcomes, including mortality, relapse, and ESRD development, were determined.
Results
Overall, 39 (18.5%) patients developed ESRD owing to the progression of AAV‐associated renal disease. The median FI was higher in AAV patients with ESRD than in those without (1.61 vs 1.04; P = .001). The FI cut‐off was 1.72. The incidence of ESRD was higher in patients with FI ≥ 1.72 at the time of diagnosis than in those with an FI < 1.72 at the time of diagnosis (relative risk: 4.655; 95% confidence interval: 2.242‐9.662; P < .001). Kaplan‐Meier survival analysis revealed that patients with an FI ≥ 1.72 at the time of diagnosis exhibited significantly lower ESRD‐free survival rates than those with an FI < 1.72 at the time of diagnosis (P < .001).
Conclusion
FI ≥ 1.72 at the time of diagnosis may be an independent predictive marker for ESRD in AAV patients.</abstract><cop>England</cop><pub>Hindawi Limited</pub><pmid>33301633</pmid><doi>10.1111/ijcp.13929</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9446-1892</orcidid><orcidid>https://orcid.org/0000-0002-1866-6885</orcidid><orcidid>https://orcid.org/0000-0002-0897-661X</orcidid><orcidid>https://orcid.org/0000-0003-0662-7704</orcidid><orcidid>https://orcid.org/0000-0002-8038-3341</orcidid><orcidid>https://orcid.org/0000-0002-9002-9880</orcidid><orcidid>https://orcid.org/0000-0003-4695-8620</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1368-5031 |
| ispartof | International journal of clinical practice (Esher), 2021-04, Vol.75 (4), p.e13929-n/a |
| issn | 1368-5031 1742-1241 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications Antibodies, Antineutrophil Cytoplasmic Antineutrophil cytoplasmic antibodies Diagnosis Fibrosis Humans Immunosuppressive agents Kidney diseases Kidney Failure, Chronic - etiology Kidneys Liver diseases Medical records Patients Retrospective Studies Survival Survival analysis Vasculitis |
| title | Efficacy of the fibrosis index for predicting end‐stage renal disease in patients with antineutrophil cytoplasmic antibody‐associated vasculitis |
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