Photo Credit: Wiedia Wiedia
The following is a summary of “Prognostic value of two histopathologic classification models of ANCA-associated glomerulonephritis: a prospective study,” published in the February 2024 issue of Nephrology by Christodoulou et al.
The Berden Classification and anti-neutrophil cytoplasmic antibody (ANCA) Renal Risk Score are classification models used to assess renal histology and predict outcomes in patients with ANCA-associated Vasculitis/Glomerulonephritis (AAV/GN).
Researchers conducted a retrospective study to assess and compare the predictive capabilities of the Berden Classification and ANCA Renal Risk Score for renal function outcomes during short- and long-term follow-up.
They classified patients with an initial diagnosis of AAV/GN based on kidney biopsy according to Berden and Renal Risk Score, initiated them on the same treatment protocol, and prospectively followed them for up to 60 months. Renal function was assessed at 3 months (T3), 6 months (T6), and 60 months (T60), and the findings were compared using both classification systems.
The results showed that 94 AAV/GN patients were included, M/F = 36/58, age = 60.05 (18–82)yrs. Based on the Berden classification, patients were grouped as Focal (n = 24), Crescentic (n = 35), Mixed (n = 21), and Sclerotic (n = 14), with significant differences in estimated glomerular filtration rate (eGFR) only at T3. The percentage of those requiring hemodialysis differed at T0, T3, and T6 but not at T60. According to the Renal Risk Score, patients were classified as Low (n = 8), Medium (n = 47), and High (n = 39) risk, showing significant differences in both eGFR levels, the proportion of hemodialysis, at T0, T3, T6, and end-stage kidney disease (ESKD) at T60. Even patients classified as Mixed (Berden) and Medium or High risk (Renal Risk Score) significantly improved from T0 to T6. Either system could not predict relapse.
Investigators concluded that while both methods predicted short-term outcomes, the Renal Risk Score was superior for long-term kidney function and ESKD prediction.
Source: link.springer.com/article/10.1007/s40620-023-01855-x
