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      Correlation of Percentage of Normal Glomeruli with Renal Outcome in Wegener’s Granulomatosis


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          Background/Aims: We examined the correlations between renal biopsy findings in Wegener’s granulomatosis and renal function at baseline and 1 year in 22 patients who presented between 1988 and 1999. Methods: Renal histology was independently reviewed by 2 pathologists who were masked to the clinical data. The primary outcome was the relationship of the percentage of normal glomeruli to reciprocal serum creatinine at baseline and 1 year. Other histologic data were collected using a series of ordinal rating scales. Acute and chronic sum scores were calculated. Results: The median serum creatinine (SCr) at baseline was 3.9 mg/dl (0.8–14 mg/dl). Seven patients initially required hemodialysis, of whom 4 subsequently regained independent renal function. By 1 year of follow-up, the median (SCr) for patients with independent renal function was 1.9 mg/dl (0.9–6.8 mg/dl). Reciprocal SCr at baseline correlated with the percentage of normal glomeruli (r = 0.584, p = 0.005), crescent score (r = –0.595, p = 0.003), interstitial fibrosis as a percentage of cortical surface area (r = –0.669, p = 0.002), interstitial inflammation (r = –0.439, p = 0.041), eosinophil (r = –0.495, p = 0.019), neutrophil score (r = –0.557, p = 0.005), and acute sum score (r = –0.499, p = 0.018). However, only the percentage of normal glomeruli (r = 0.493, p = 0.023), the crescent score (r = –0.452, p = 0.035), and interstitial fibrosis as a percentage of cortical surface area (r = –0.466, p = 0.052) correlated with reciprocal SCr at 1 year of follow-up. Conclusion: In this relatively small data set, the percentage of normal glomeruli, the crescent score, and interstitial fibrosis as a percentage of cortical surface area correlated with renal function at both baseline and 1 year of follow-up.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          December 2002
          07 October 2002
          : 22
          : 5-6
          : 497-503
          Divisions of aNephrology and bRheumatology, The Johns Hopkins Vasculitis Center, Department of Medicine; cDepartment of Pathology, Johns Hopkins University Hospital, Baltimore, Md., USA
          65283 Am J Nephrol 2002;22:497–503
          © 2002 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 14 August 2001
          : 11 June 2002
          Page count
          Figures: 1, Tables: 3, References: 15, Pages: 7
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/65283
          Self URI (text/html): https://www.karger.com/Article/FullText/65283
          Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
          Clinical Study

          Cardiovascular Medicine,Nephrology
          Glomerulonephritis,Wegener’s granulomatosis,Anti-neutrophil cytoplasmic antibodies,Renal biopsy


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