The following is the summary of “Clinicopathological characteristics and outcome predictors of anti-glomerular basement membrane glomerulonephritis” published in the November 2022 issue of Renal failure by Ge, et al.
Determine the predictive significance of clinical and laboratory markers at diagnosis of anti-glomerular basement membrane (anti-GBM) glomerulonephritis (anti-GBM-GN) and its effect on renal and patient survival. During the study period of January 2010 through June 2021, 76 patients (34 men and 42 females) were included who were diagnosed with anti-GBM-GN while hospitalized at the First Affiliated Hospital of Nanjing Medical University. Predictors of renal and patient survival were examined in conjunction with baseline clinical characteristics and histological data from renal biopsies.
Estimated glomerular filtration rate (eGFR) was 6.62 (4.39, 14.41) mL/min at diagnosis, with a median serum creatinine of 618.0 (350.98, 888.25) μmol/L among the 76 individuals. Only 39 (51%) of these 76 patients had plasma exchange or double-filtered plasmapheresis as their first line of treatment, whereas 55 (72%) had kidney replacement therapy (KRT) as their first line of treatment double-filtered plasmapheresis (DFPP). About 53 (69.7%) patients developed kidney failure requiring replacement therapy (KFRT) and were placed on maintenance dialysis over the course of the study’s median follow-up period of 28.5 (6.0, 71.8) months. The chance of dying from renal failure was significantly increased after initial KRT (HR=3.48, 95% CI=1.22-9.97, P=0.020).
During the observation period, 49 patients (64.5%) out of 76 survived. Patient survival was predicted by both age (≥60 years, HR = 4.13, 95% CI=1.65-10.38, P=0.003) and first KRT (HR= 2.87, 95% CI=1.01-8.14, P=0.047). Patients with anti-GBM-GN were more likely to have KFRT if they underwent KRT soon after diagnosis, while those who were older at presentation and those who underwent KRT first had a higher risk of dying from any cause.