Izvorni znanstveni članak
https://doi.org/10.20471/acc.2021.60.s1.22
Outcome in Elderly Patients with Anca – Associated Glomerulonephritis Managed with Immunosuppressive Treatment
Karlo Kurtov
; Department of Emergency Medicine Sisak-Moslavina County
Mario Laganović
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia; School of Medicine, University of Zagreb
Sandra Karanović
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia; School of Medicine, University of Zagreb
Živka Dika
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia; School of Medicine, University of Zagreb
Ema Ivandić
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia
Marijana Živko
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia
Jelena Kos
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia
Margareta Fištrek
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia
Bojan Jelaković
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia; School of Medicine, University of Zagreb
Ivana Vuković Brinar
; Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia; School of Medicine, University of Zagreb
Sažetak
The most common cause of rapidly progressive glomerulonephritis in elderly, antineutrophil
cytoplasmic antibody-associated glomerulonephritis (ANCA-GN), demands immunosuppressive
therapy (IS) regimen in a multi-morbid disease burdened population. Our aim was to
assess outcome differences in two age groups.
The study included a total of 38 ANCA-GN renal limited patients (18 men) treated from 1990 to
2018, of which 11 were 65 years of age and older (median 70, min. - max. 66 - 79 years), and 27
younger than 65 (median 55, min. - max. 23 - 64 years). All patients were treated with mono/combination
of IS.
Most commonly applied IS in elderly was combination of IV cyclophosphamide and corticosteroids
(CS) (in 9 [81.8%]), while in younger it was a combination of CS and cyclophosphamide or
rituximab (59.2%). Older patients had comparable mortality (3, [14.8%] vs. 4, [27.3%]; P = 0.369),
malignancies (1, [3.7%] vs. 1, [9.1%]; P = 0.5) and infectious complications (10, [46.7%] vs. 7, [63.6%];
P = 0.388). Ten patients at the end of the follow up were at renal replacement therapy (RRT ), with no
difference between age groups (6, [22.2%] vs. 4, [36.4%]; P = 0.369). Interestingly, from initial need
for RRT , half of the younger and older patients recovered with IS.
Our findings give more credit to the current paradigm to treat elderly ANCA-GN patients with
IS therapy due to the similar outcome of elderly as younger ones.
Ključne riječi
Antineutrophil Cytoplasmic antibodies; Glomerulonephritis; Elderly; Immunosuppression; Mortality; Kidney failure
Hrčak ID:
260436
URI
Datum izdavanja:
1.1.2021.
Posjeta: 694 *