Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis: a nationwide retrospective study in China
作者全名："Tan, Li-Wen; Wan, Jun-Li; Zhu, Chun-Hua; Xu, Hong; Xia, Zheng-Kun; Chen, Li-Zhi; Wu, Xiao-Chuan; Wang, Fang; Liu, Xiao-Rong; Zhao, Cheng-Guang; Li, Xiao-Zhong; Mao, Jian-Hua; Wang, Xiao-Wen; Huang, Wen-Yan; Li, Yu-Hong; Zhang, Jian-Jiang; Feng, Shi-Pin; Yang, Jun; Liu, Jiao-Jiao; Gao, Chun-Lin; Rong, Li-Ping; Shuai, Lan-Jun; Xu, Ke; Zhang, He-Jia; Li, Qiu; Zhang, Ai-Hua; Wang, Mo"
作者地址："[Tan, Li-Wen; Wan, Jun-Li; Li, Qiu; Wang, Mo] Chongqing Med Univ, Childrens Hosp, Dept Nephrol, Zhongshan 2nd Rd 136, Chongqing 400014, Peoples R China; [Tan, Li-Wen; Wan, Jun-Li; Li, Qiu; Wang, Mo] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Tan, Li-Wen; Wan, Jun-Li; Li, Qiu; Wang, Mo] Chongqing Med Univ, Childrens Hosp, Chongqing Key Lab Pediat, Chongqing, Peoples R China; [Zhu, Chun-Hua; Zhang, Ai-Hua] Nanjing Med Univ, Childrens Hosp, Dept Nephrol, 72 Guangzhou Rd, Nanjing 210008, Peoples R China; [Xu, Hong; Liu, Jiao-Jiao] Fudan Univ, Childrens Hosp, Natl Paediat Med Ctr China, Dept Nephrol, Shanghai, Peoples R China; [Xia, Zheng-Kun; Gao, Chun-Lin] Nanjing Med Univ, Jinling Hosp, Dept Pediat, Nanjing, Peoples R China; [Xia, Zheng-Kun; Gao, Chun-Lin] Southern Med Univ, Jinling Hosp, Sch Clin Med 1, Dept Pediat, Nanjing, Peoples R China; [Xia, Zheng-Kun; Gao, Chun-Lin] Nanjing Univ, Jinling Hosp, Med Sch, Dept Pediat, Nanjing, Peoples R China; [Chen, Li-Zhi; Rong, Li-Ping] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Pediat Nephrol & Rheumatol, Guangzhou, Peoples R China; [Wu, Xiao-Chuan; Shuai, Lan-Jun] Cent South Univ, Xiangya Hosp 2, Dept Pediat, Changsha, Peoples R China; [Wang, Fang; Xu, Ke] Peking Univ First Hosp, Dept Pediat, Beijing, Peoples R China; [Liu, Xiao-Rong; Zhang, He-Jia] Capital Med Univ, Beijing Childrens Hosp, Dept Nephrol, Beijing 100045, Peoples R China; [Liu, Xiao-Rong; Zhang, He-Jia] Natl Ctr Childrens Hlth, Beijing, Peoples R China; [Zhao, Cheng-Guang] China Med Univ, Shengjing Hosp, Dept Pediat, Shenyang, Peoples R China; [Li, Xiao-Zhong] Soochow Univ, Childrens Hosp, Dept Nephrol & Immunol, Suzhou, Peoples R China; [Mao, Jian-Hua] Zhejiang Univ, Sch Med, Childrens Hosp, Dept Nephrol, Hangzhou, Peoples R China; [Wang, Xiao-Wen] Huazhong Univ Sci & Technol, Wuhan Childrens Hosp, Wuhan Maternal & Child Healthcare Hosp, Tongji Med Coll,Dept Nephrol, Wuhan, Peoples R China; [Huang, Wen-Yan] Shanghai Jiao Tong Univ, Shanghai Childrens Hosp, Sch Med, Dept Nephrol & Rheumatol, Shanghai, Peoples R China; [Li, Yu-Hong] Guiyang Maternal & Child Hlth Care Hosp, Pediat Nephrol Dept, Guiyang, Peoples R China; [Zhang, Jian-Jiang] Zhengzhou Univ, Affiliated Hosp 1, Dept Pediat, Zhengzhou, Peoples R China; [Feng, Shi-Pin] Chengdu Women & Children Cent Hosp, Dept Nephrol, Chengdu 610041, Peoples R China; [Yang, Jun] Shenzhen Childrens Hosp, Dept Rheumatol & Immunol, Shenzhen, Peoples R China"
通信作者："Wang, M (通讯作者)，Chongqing Med Univ, Childrens Hosp, Dept Nephrol, Zhongshan 2nd Rd 136, Chongqing 400014, Peoples R China.; Wang, M (通讯作者)，Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China.; Wang, M (通讯作者)，Chongqing Med Univ, Childrens Hosp, Chongqing Key Lab Pediat, Chongqing, Peoples R China.; Zhang, AH (通讯作者)，Nanjing Med Univ, Childrens Hosp, Dept Nephrol, 72 Guangzhou Rd, Nanjing 210008, Peoples R China."
来源：WORLD JOURNAL OF PEDIATRICS
ESI学科分类：CLINICAL MEDICINE
WOS号：WOS:001086382000001
JCR分区：Q1
影响因子：8.7
年份：2023
卷号：
期号：
开始页：
结束页：
文献类型：Article; Early Access
关键词：Antineutrophil cytoplasmic antibody; End-stage renal disease; Glomerulonephritis; Pediatric nephrology; Vasculitis
摘要："Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a life-threatening systemic vasculitis featured by liability to renal involvement. However, there are few studies on the risk factors and predictive models for renal outcomes of AAV in children.Methods Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively. The risk factors and predictive model of end-stage renal disease (ESRD) in AAV were explored.Results Renal involvement was the most typical manifestation (95.5%), and the crescent was the predominant pathological lesion (84.9%). The estimated glomerular filtration rate (eGFR) was evaluated in 114 patients, of whom 59.6% developed ESRD, and the median time to ESRD was 3.20 months. The eGFR [P = 0.006, odds ratio (OR) = 0.955, 95% confidence interval (CI) = 0.924-0.987] and the percentages of global glomerulosclerosis (pGGS; P = 0.018, OR = 1.060, 95% CI = 1.010-1.112) were independent risk factors for ESRD of renal biopsy. Based on the pGGS and eGFR at renal biopsy, we developed three risk grades of ESRD and one predictive model. The Kaplan-Meier curve indicated that renal outcomes were significantly different in different risk grades (P < 0.001). Compared with serum creatinine at baseline, the predictive model had higher accuracy (0.86 versus 0.58, P < 0.001) and a lower coefficient of variation (0.07 versus 0.92) in external validation.Conclusions Renal involvement is the most common manifestation of pediatric AAV in China, of which more than half deteriorates into ESRD. The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children."
基金机构："Thanks to all the AAV children enrolled in the study and their guardians. We are grateful to Jia-Cheng Li and Xi-Ming Xu of Children's Hospital of Chongqing Medical University for providing statistical analysis, and Wen-Hao Wang from Queen Mary University"
基金资助正文："Thanks to all the AAV children enrolled in the study and their guardians. We are grateful to Jia-Cheng Li and Xi-Ming Xu of Children's Hospital of Chongqing Medical University for providing statistical analysis, and Wen-Hao Wang from Queen Mary University of London for revising the language."
