Clinical analysis of renal involvement in eosinophilic granulomatosis with polyangiitis

doi:10.3969/j.issn.1006-7795.2023.03.021

Abstract

Abstract: Objective To describe the clinical features of renal involvement with eosinophilic granulomatosis with polyangiitis (EGPA) in patients. Methods Patients who fulfilled the criteria of EGPA managed at the Beijing Chaoyang Hospital， Capital Medical University from May 2005 to December 2021 were retrospectively analyzed. The clinical data of patients with renal involvement were analyzed, the differences between patients with and without chronic kidney disease were compared. The risk factors of EGPA with renal involvement were analyzed.Results Among 104 patients with EGPA, 55 were males and 49 were females, with a median age of 56 (46， 65) years at the time of diagnosis. Asthma was the most common symptom in 99 patients (95.2%), 82 patients (78.8%) with eosinophilia (>10%), ANCA was positive in 20 patients (19.2%). There were 59 patients (56.7%) with renal involvement, including 30 patients (28.8%) with microscopic hematuria, 11 patients (10.6%) with proteinuria, 38 patients (36.5%) with decreased estimated glomerular filtration rate ［eGFR<80 mL/（min·1.73 m2）］, and 11 patients (10.6%) with chronic kidney disease ［eGFR<60 mL/（min·1.73 m2）］. ANCA positive patients were more likely to have renal involvement than ANCA negative patients. In patients with chronic kidney disease, the hemoglobin level was significantly decreased (U=212.50, P=0.002), and the incidence of heart involvement was significantly increased (χ²=5.610, P=0.018). Multivariate analysis suggested that advanced age and ANCA positive were independent risk factors for EGPA renal involvement. The median follow-up time was 41 (19, 59) months, 6 patients died, 3 with chronic kidney disease. Conclusions Renal involvement in patients with EGPA is mainly manifested by hematuria, proteinuria and a mild decreased renal function. Advanced age and ANCA positive are independent risk factors for renal involvement. Patients with chronic kidney disease have an increased incidence of both anemia and cardiac involvement.

Key words: eosinophilic granulomatous polyvasculitis, renal involvement, glomerular filtration rate, chronic kidney disease

CLC Number:

R543

Li Jie, Zhang Jun, Wang Jing, Hua Lin, Zhang Liming. Clinical analysis of renal involvement in eosinophilic granulomatosis with polyangiitis[J]. Journal of Capital Medical University, 2023, 44(3): 494-500.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2023.03.021

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2023/V44/I3/494

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