ABSTRACT
Objective To assess the predictive value of Berden classification in ANCA associated glomerulonephritis.Methods Patients with confirmed ANCA associated glomerulonephritis were included,by retrieving the medical database in Peking Union Medical College Hospital from January 2000 to May 2015.Their detailed information during hospitalization and follow-up was recorded.The patients were divided into four categories based on Berden classification.The differences in clinical characters,renal function and response for treatment were compared.Results Among the 88 patients with ANCA-associated glomerulonephritis,19 (21.6％),21 (23.9％),32 (36.4％)and 16 (18.2％) patients were classified as focal,mixed,crescentic and sclerotic category.22 patients developed ESRD,and 19 patients died during follow up (1 patient developed ESRD before died).The mean estimated glomerular filtration rate (eGFR) at baseline was 68.04,25.45,30.04,15.16 ml·min-1·(1.73 m2)-1 (P ＜ 0.05) in focal,crescentic,mixed and sclerotic category,respectively.During follow-up period,focal category always had the best renal function,while sclerotic category had the worst renal function.Crescentic category and mixed category were similar and in the middle.Remission rate at 6m was 62.5％,73.7％,57.5％,30.8％(P ＞ 0.05).And crescentic category had the greatest improvement in eGFR at 6m.Conclusions Focal category had relatively preserved renal function and favorable renal outcome,while the sclerotic category had the worst renal outcome.Crescentic and mixed category had an intermediate outcome.We support the use of the Berden classification in predicting the renal prognosis of patients with ANCA associated glomerulonephritis.
ABSTRACT
Anti-neutrophil cytoplasmic antibody ( ANCA)-associated glomerulonephritis is the most common cause of rapidly progressive glomerulonephritis worldwide , and the renal biopsy is not only the gold standard for establishing the diagnosis ,but also help-ful to judge the prognosis in clinical practice .In 2010,Berden et al presented a pathologic classification which proposed four general categories of lesions:Focal, crescentic, mixed, and sclerotic.And then, several validation studies proved the prognostic value of this classification.However, the difference of renal survival is large in various pathological types among different studies , so it needs more studies to develop its prognostic value .This review mainly focuses on clinical significance , definition of pathological feature , and vali-dation study about this classification .
ABSTRACT
Anti-neutrophil cytoplasmic antibody ( ANCA)-associated glomerulonephritis is the most common cause of rapidly progressive glomerulonephritis worldwide , and the renal biopsy is not only the gold standard for establishing the diagnosis ,but also help-ful to judge the prognosis in clinical practice .In 2010,Berden et al presented a pathologic classification which proposed four general categories of lesions:Focal, crescentic, mixed, and sclerotic.And then, several validation studies proved the prognostic value of this classification.However, the difference of renal survival is large in various pathological types among different studies , so it needs more studies to develop its prognostic value .This review mainly focuses on clinical significance , definition of pathological feature , and vali-dation study about this classification .
ABSTRACT
Objective To explore the relation between vitamin D deficiency and susceptibility to spinal tuberculosis. Methods A total of 163 hospitalized patients with untreated spinal tuberculosis in Tianjin Haihe hospital were enrolled in this study from June 2013 to May 2016. A total of 170 individuals participated in health examination program at the same period were enrolled as the control group. The serum level of 25-hydroxyvitamin D [25(OH)D] was measured by enzyme linked immunosorbent assay. The 25(OH)D grading included serious deficiency group (0.05). In patient group, there were 107 cases of caseous necrosis type, 56 cases of hyperplasia type, and the proportion of caseous necrosis type was significantly higher in the severe deficiency group (79.17%, 76/96) than that of deficiency group (46.27%, 31/67, P<0.01). Conclusion Excluding the effect of season, vitamin D deficiency is associated with susceptibility to spinal tuberculosis and histopathologic classification.