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Kidney Outcomes in ANCA-Glomerulonephritis According to Induction Immunosuppression and Histopathology - PubMed

a day ago
  • #immunosuppression
  • #ANCA-glomerulonephritis
  • #kidney outcomes
  • Cyclophosphamide (CYC) and rituximab (RTX) are main induction therapies for ANCA-glomerulonephritis.
  • Study explores if kidney histopathology affects response to induction therapy.
  • Retrospective, multicenter study with 304 patients; median baseline eGFR was 20 ml/min per 1.73 m².
  • Induction therapies: CYC (59%), RTX (17%), RTX-CYC (24%).
  • 50% recovered kidney function; 19.4% had kidney failure over median 42-month follow-up.
  • In crescentic class, RTX monotherapy had lower eGFR recovery odds vs. CYC (OR: 0.23).
  • RTX monotherapy marginally increased kidney failure risk in crescentic class vs. CYC (HR: 3.42).
  • No significant outcome differences in other Berden histopathology classes.
  • Conclusion: Crescentic class ANCA-glomerulonephritis patients on RTX monotherapy may have worse outcomes than CYC-based regimens.