1. Kidney Histopathology Can Predict Kidney Function in ANCA-Associated Vasculitides with Acute Kidney Injury Treated with Plasma Exchanges
- Author
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Nezam, Dorian, Porcher, Rapha?l, Grolleau, Fran?ois, Morel, Pauline, Titeca-Beauport, Dimitri, Faguer, Stanislas, Karras, Alexandre, Solignac, Justine, Jourde-Chiche, No?mie, Maurier, Fran?ois, Sakhi, Hamza, El Karoui, Khalil, Mesbah, Rafik, Carron, Pierre Louis, Audard, Vincent, Ducloux, Didier, Paule, Romain, Augusto, Jean-Fran?ois, Aniort, Julien, Tiple, Aur?lien, Rafat, C?dric, Beaudreuil, S?verine, Pu?chal, Xavier, Gobert, Pierre, Massy, Ziad, Hanrotel, Catherine, Bally, St?phane, Martis, Nihal, Durel, C?cile-Audrey, Desbuissons, Geoffroy, Godmer, Pascal, Hummel, Aur?lie, Perrin, Fran?ois, N?el, Antoine, De Moreuil, Claire, Goulenok, Tiphaine, Guerrot, Dominique, Grange, Steven, Foucher, Aur?lie, Deroux, Alban, Cordonnier, Carole, Guilbeau-Frugier, C?line, Modesto-Segonds, Anne, Nochy, Dominique, Daniel, Laurent, Moktefi, Anissa, Rabant, Marion, Guillevin, Lo?c, R?gent, Alexis, and Terrier, Benjamin
- Abstract
Findings of the international prospective multicenter PEXIVAS trial challenge the role of PLEX in AAV. We conducted a retrospective study of 425 patients: 188 with AAV and renal failure treated with PLEX and 237 not treated. A score to identify patients who would benefit from PLEX was developed. With kidney biopsy data, scores more than seven achieved sensitivity and specificity of 83.1% and 96.0%, respectively, for recommending PLEX. The average effect of PLEX for those with recommended treatment corresponded to an absolute risk reduction for death or KRT at M12 of 24.6%. Patients in the PLEX-recommended group had microscopic polyangiitis, MPO-ANCA, higher serum creatinine, crescentic and sclerotic classes, and higher Brix score. These findings, which require independent validation, could provide guidance in selecting patients with AAV who will benefit from PLEX.
- Published
- 2022
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