Evidence map›Paper›PMID 36498699›Full record

ArticleJournal of clinical medicine2022

The Presence of ANCA in IgA Crescentic Nephropathy Does Not Lead to Worse Prognosis with Intensive Rescue Treatment.

Irene Agraz, Zaira Castañeda, María Teresa Sanz-Martínez, Alejandra Gabaldón, Sheila Bermejo, Laura Viñas Gimenez, Roxana Bury, Mónica Bolufer, Marina López-Martínez, Natalia Ramos and 2 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 50% of its field
1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Irene AgrazDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.ORCID 0000-0002-4223-6834
Zaira CastañedaDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.
María Teresa Sanz-MartínezDepartment of Immunology, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
Alejandra GabaldónDepartment of Pathology, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
Sheila BermejoDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.ORCID 0000-0002-3611-4830
Laura Viñas GimenezDepartment of Immunology, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
Roxana BuryDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.
Mónica BoluferDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.
Marina López-MartínezDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.
Natalia RamosDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.
Oriol BestardDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.
María José SolerDepartment of Nephrology, Vall d'Hebron University Hospital, Reference Center for Complex Glomerular Diseases (CSUR), 08035 Barcelona, Spain.ORCID 0000-0003-3621-0766
Vall d'Hebron Hospital Universitari · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmunoglobulin A nephropathy (IgAN) is the most common glomerulonephritis worldwide. The concomitant presence of both crescentic proliferation and anti-neutrophil cytoplasmic autoantibodies (ANCA) in this pathology represents a rare coincidence. However, it is not clear to what extent the presence of ANCA (IgA or IgG) in these patients could have any clinical significance. The aim of the current work is to describe the presence of ANCA (IgA or IgG) in patients with IgAN and crescentic proliferation and its possible clinical implications.

methodsWe retrospectively recruited all patients in our center with a histological diagnosis of IgAN with crescentic proliferation between January 2013 and December 2020. The main demographic and clinicopathologic data, fundamental histological characteristics, as well as the treatments implemented and main kidney outcomes, were collected and analyzed at a 6 and 12-month follow-up.

resultsBetween January 2013 and December 2020, a total of 17 adults were diagnosed with concomitant crescentic proliferation through a kidney biopsy of IgAN. Five (29.4%) patients showed ANCA, three (60%) showed IgA-ANCA and two (40%) showed IgG-ANCA. All ANCA-positive patients had some degree of crescentic proliferation. At diagnosis, the mean age of patients was 48 years old (range: 27-75). Nine of them were women (52%) and the most common clinical presentation was hypertension (71%). At the time of biopsy, the mean serum creatinine and proteinuria were 2.2 mg/dL (DS 1.42) and 3.5 g/mgCr (DS 1.22), respectively, with no statistical differences between ANCA-positive and -negative patients. Histological analyses showed that 11 out of the 12 (91%) ANCA-negative IgAN patients displayed less than 25% cellular crescents, whereas 100% of ANCA-positive IgAN patients displayed more than 25% cellular crescents (

conclusionsProbably due to the limited number of IgAN-ANCA-positive and IgAN-ANCA-negative patients, no significant differences were found between the clinical and laboratory characteristics. IgAN-ANCA-negative patients seemed to display less extracapillary proliferation than IgAN-ANCA-positive patients, who tended to show significantly higher fibrinoid necrosis. There were no differences regarding renal prognosis and patient survival after aggressive immunosuppressive therapy within 6 and 12 months when comparing the two samples.

Indexed as

antineutrophil cytoplasmic autoantibodies (ANCA)crescentsIgA nephropathy

Identifiers

PMID36498699
PMCPMC9738508
OpenAlexW4310396570

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.