Slot et al identified prognostic factors for a patient with proteinase-3 (PR3) ANCA associated vasculitis with renal involvement. The authors are from University Hospital Maastricht and University Hospital Groningen in The Netherlands.
Anti-Neutrophil Cytoplasmic Antibodies (ANCA) may be directed to:
(1) myeloperoxidase (MPO)
(2) proteinase-3 (PR3)
ANCA may be associated with:
(1) Wegener's granulomatosis
(2) microscopic polyangiitis
Patient selection: PR3-related ANCA and renal involvement
Risk factors associated with death within 1 year (Table 3, page 675):
(1) age > 65 years
(2) dialysis dependency at diagnosis
(3) significant increase in C-reactive protein (CRP) in mg/L
Risk factors associated with poor prognosis (death in more than 1 year):
(1) male gender
(2) development of dialysis dependency during followup
Additional risk factor associated with renal failure in more than 1 year:
(1) renal relapse
This will eventually lead to dialysis dependency during the followup period.
Therapy to prevent renal relapses can preserve renal function which will impact long-term survival.
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