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Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment

Renal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring...

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Autores principales: Hakroush, Samy, Tampe, Desiree, Korsten, Peter, Ströbel, Philipp, Zeisberg, Michael, Tampe, Björn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900153/
https://www.ncbi.nlm.nih.gov/pubmed/33634143
http://dx.doi.org/10.3389/fmed.2020.622028
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author Hakroush, Samy
Tampe, Desiree
Korsten, Peter
Ströbel, Philipp
Zeisberg, Michael
Tampe, Björn
author_facet Hakroush, Samy
Tampe, Desiree
Korsten, Peter
Ströbel, Philipp
Zeisberg, Michael
Tampe, Björn
author_sort Hakroush, Samy
collection PubMed
description Renal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring RRT at admission, we here aimed to evaluate histopathological findings and predictive value of Berden's histopathological subgrouping and ARRS for severity of AKI and requirement of RRT during the short-term clinical course in critically ill patients requiring intensive care treatment and predictors for short-term renal recovery in patients requiring RRT. A subgroup of 15/46 (32. 6%) AAV patients with biopsy-proven AAV required RRT during the short-term course of disease, associated with requirement of critical care treatment. While histopathological subgrouping and ARRS were associated with requirement of acute RRT, presence of global glomerular scarring was the strongest predictor of failure to recover from RRT after initiation of remission induction therapy. This new aspect requires further investigation in a prospective controlled setting for therapeutic decision making especially in this subgroup.
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spelling pubmed-79001532021-02-24 Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment Hakroush, Samy Tampe, Desiree Korsten, Peter Ströbel, Philipp Zeisberg, Michael Tampe, Björn Front Med (Lausanne) Medicine Renal involvement is a common and severe complication of AAV as it can cause ESRD. Histopathological subgrouping and ARRS are helpful to predict long-term ESRD in patients with AAV. Because a subgroup of critically ill patients with severe AAV present with deterioration of kidney function requiring RRT at admission, we here aimed to evaluate histopathological findings and predictive value of Berden's histopathological subgrouping and ARRS for severity of AKI and requirement of RRT during the short-term clinical course in critically ill patients requiring intensive care treatment and predictors for short-term renal recovery in patients requiring RRT. A subgroup of 15/46 (32. 6%) AAV patients with biopsy-proven AAV required RRT during the short-term course of disease, associated with requirement of critical care treatment. While histopathological subgrouping and ARRS were associated with requirement of acute RRT, presence of global glomerular scarring was the strongest predictor of failure to recover from RRT after initiation of remission induction therapy. This new aspect requires further investigation in a prospective controlled setting for therapeutic decision making especially in this subgroup. Frontiers Media S.A. 2021-02-09 /pmc/articles/PMC7900153/ /pubmed/33634143 http://dx.doi.org/10.3389/fmed.2020.622028 Text en Copyright © 2021 Hakroush, Tampe, Korsten, Ströbel, Zeisberg and Tampe. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Hakroush, Samy
Tampe, Desiree
Korsten, Peter
Ströbel, Philipp
Zeisberg, Michael
Tampe, Björn
Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
title Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
title_full Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
title_fullStr Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
title_full_unstemmed Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
title_short Histopathological Findings Predict Renal Recovery in Severe ANCA-Associated Vasculitis Requiring Intensive Care Treatment
title_sort histopathological findings predict renal recovery in severe anca-associated vasculitis requiring intensive care treatment
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900153/
https://www.ncbi.nlm.nih.gov/pubmed/33634143
http://dx.doi.org/10.3389/fmed.2020.622028
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