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Efficacy of the fibrosis index for predicting end-stage renal disease in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Authors
 Jung Yoon Pyo  ;  Sung Soo Ahn  ;  Lucy Eunju Lee  ;  Ha Na Choe  ;  Jason Jungsik Song  ;  Yong-Beom Park  ;  Sang-Won Lee 
Citation
 INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Vol.75(4) : e13929, 2021-04 
Journal Title
 INTERNATIONAL JOURNAL OF CLINICAL PRACTICE 
ISSN
 1368-5031 
Issue Date
2021-04
Abstract
Objective: Kidney involvement is a major manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and may progress to end-stage renal disease (ESRD), requiring renal replacement therapy. Unfortunately, there is no reliable kidney-specific index for predicting the progression of renal disease to ESRD. The fibrosis index (FI) reflects the degree of fibrosis in chronic liver disease. This study aimed to investigate whether the FI at the time of diagnosis could predict the development of ESRD in AAV patients. Methods: We retrospectively reviewed the medical records of 211 immunosuppressive drug-naïve AAV patients and extrapolated the cut-off FI value for predicting the development of ESRD using receiver operating characteristic curves. The associations between the FI and clinical outcomes, including mortality, relapse, and ESRD development, were determined. Results: Overall, 39 (18.5%) patients developed ESRD owing to the progression of AAV-associated renal disease. The median FI was higher in AAV patients with ESRD than in those without (1.61 vs 1.04; P = .001). The FI cut-off was 1.72. The incidence of ESRD was higher in patients with FI ≥ 1.72 at the time of diagnosis than in those with an FI < 1.72 at the time of diagnosis (relative risk: 4.655; 95% confidence interval: 2.242-9.662; P < .001). Kaplan-Meier survival analysis revealed that patients with an FI ≥ 1.72 at the time of diagnosis exhibited significantly lower ESRD-free survival rates than those with an FI < 1.72 at the time of diagnosis (P < .001). Conclusion: FI ≥ 1.72 at the time of diagnosis may be an independent predictive marker for ESRD in AAV patients.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/ijcp.13929
DOI
10.1111/ijcp.13929
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Song, Jason Jungsik(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Lee, Sang-Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Lee, Lucy Eunju(이은주)
Pyo, Jung Yoon(표정윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182315
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