Clinical and pathologic characteristics of pauci-immune anti-myeloperoxidase antibody associated glomerulonephritis with nephrotic range proteinuria

Figures & data

Table 1. Comparison of clinical features of patients with and without nephrotic proteinuria.

Feature	Non-nephrotic proteinuria (n = 112)	Nephrotic proteinuria (n = 20)	p value
Male/female	63/49	9/11	.352
Age (years)	59.00 ± 14.18	54.55 ± 17.52	.215
Time from onset (days)	90 (14, 210)	90 (14, 150)	.625
BVAS	20.27 ± 5.38	20.15 ± 5.80	.924
Acute kidney failure (Y/N)	86/26	20/0	.016
Dialysis on admission (Y/N)	19/93	8/12	.019
Gross hematuria (Y/N)	23/89	9/11	.019
Edema (Y/N)	32/80	11/9	.020
Fever (Y/N)	62/50	13/7	.423
Weight loss (Y/N)	51/61	3/17	.011
Muscle/joint (Y/N)	38/74	3/17	.092
Skin (Y/N)	16/96	4/16	.511
Eyes/mucous membranes (Y/N)	20/92	2/18	.385
Ear/nose/throat (Y/N)	49/63	4/16	.046
Lung (Y/N)	50/62	10/10	.658
Cardiovascular (Y/N)	5/107	0/20	.335
Digestive tract (Y/N)	16/96	0/20	.071
Nervous system (Y/N)	20/92	0/20	.040

BVAS: Birmingham vasculitis activity score.

Table 2. Comparison of laboratory features of patients with and without nephrotic proteinuria.

Feature	Non-nephrotic proteinuria (n = 112)	Nephrotic proteinuria (n = 20)	p value
ANCA level (IU/mL)	98.95 ± 39.41	114.63 ± 53.47	.124
eGFR (mL/min/1.73m^2)	36.05 ± 35.62	12.33 ± 9.24	<.001
Proteinuria (g/24h)	1.35 ± 1.00	4.61 ± 1.13	<.001
Hematuria (/μL)	226.49 ± 187.36	503.47 ± 422.49	.018
Hemoglobumin (g/L)	8.98 ± 2.16	8.55 ± 1.74	.403
White blood cell (10^9/L)	9.83 ± 3.37	10.34 ± 6.95	.751
Platelet (10^9/L)	30.21 ± 14.74	28.81 ± 11.45	.687
D-Dimer (ng/mL)	2628.94 ± 2044.55	2857.65 ± 2224.28	.650
ESR (mm/h)	83.54 ± 40.13	86.10 ± 35.38	.789
Serum albumin (g/L)	31.42 ± 3.77	30.05 ± 3.16	.129
Cholesterol (mmol/L)	4.12 ± 1.06	4.28 ± 1.11	.562
Triglycerides (mmol/L)	1.34 ± 0.59	1.45 ± 0.59	.336
Complement 3 (mg/dL)	93.41 ± 21.61	94.70 ± 16.83	.801
Complement 4 (mg/dL)	36.35 ± 17.63	31.95 ± 12.81	.289
C reactive protein (mg/dL)	3.39 (0.13, 23.90)	5.07 (0.84, 22.80)	.088

ANCA: antineutrophil cytoplasmic antibody; eGFR: estimated glomerular filtration rate; ESR: erythrocyte sedimentation rate.

Figure 1. Comparison of the glomerular lesions between ANCA GN with and without nephrotic proteinuria. (A) Comparison of the ratio of normal glomeruli to total glomeruli between ANCA GN with and without nephrotic proteinuria (B) Comparison of the ratio of fibrinoid necrosis to total glomeruli between ANCA GN with and without nephrotic proteinuria. (C) Comparison of the ratio of cellular crescents to total glomeruli between ANCA GN with and without nephrotic proteinuria. (D) Comparison of the ratio of fibrous crescents to total glomeruli between ANCA GN with and without nephrotic proteinuria. (E) Comparison of the ratio of glomerular sclerosis to total glomeruli between ANCA GN with and without nephrotic proteinuria. (F) Comparison of the histopathologic classification between ANCA GN with and without nephrotic proteinuria.

Figure 2. Comparison of the prognosis between ANCA GN patients with and without nephrotic proteinuria. (A) Comparison of the proteinuria before and after treatment of patients with and without nephrotic proteinuria. Dark column: before treatment. Hollow column: after treatment. (B) Comparison of the mortality between patients with and without nephrotic proteinuria.