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ANCA-associated glomerulonephritis in the very elderly

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Presentation on theme: "ANCA-associated glomerulonephritis in the very elderly"— Presentation transcript:

1 ANCA-associated glomerulonephritis in the very elderly
Andrew S. Bomback, Gerald B. Appel, Jai Radhakrishnan, Shayan Shirazian, Leal C. Herlitz, Barry Stokes, Vivette D. D’Agati, Glen S. Markowitz  Kidney International  Volume 79, Issue 7, Pages (April 2011) DOI: /ki Copyright © 2011 International Society of Nephrology Terms and Conditions

2 Figure 1 Study flow diagram. Eighty-three patients with pauci-immune glomerulonephritis (GN) aged 80 years and above were identified, of whom 5 were excluded due to concomitant antiglomerular basement membrane disease. Of the remaining 78, 9 had no follow-up data and 8 had only limited follow-up data available, leaving 61 patients with full follow-up data (50 treated with immunosuppression, 11 untreated). CUMC, Columbia University Medical Center. Kidney International  , DOI: ( /ki ) Copyright © 2011 International Society of Nephrology Terms and Conditions

3 Figure 2 Kaplan–Meier survival curves for the outcome of end-stage renal disease (ESRD). Curves reflect univariate analyses. In multivariate Cox proportional hazards model, the use of immunosuppressive therapy significantly reduced the risk of ESRD over the duration of follow-up (hazard ratio 0.17, confidence interval 0.05–0.52, P=0.002). Kidney International  , DOI: ( /ki ) Copyright © 2011 International Society of Nephrology Terms and Conditions

4 Figure 3 Kaplan–Meier survival curves for the outcome of death. Curves reflect univariate analyses. In multivariate Cox proportional hazards model, the use of immunosuppressive therapy significantly reduced the risk of death over the duration of follow-up (hazard ratio 0.33, confidence interval 0.11–0.97, P=0.04). Kidney International  , DOI: ( /ki ) Copyright © 2011 International Society of Nephrology Terms and Conditions

5 Figure 4 Kaplan–Meier survival curves for the combined outcome of end-stage renal disease (ESRD) or death. Curves reflect univariate analyses. In multivariate Cox proportional hazards model, the use of immunosuppressive therapy significantly reduced the risk of death or ESRD over the duration of follow-up (hazard ratio 0.16, confidence interval 0.06–0.42, P<0.001). Kidney International  , DOI: ( /ki ) Copyright © 2011 International Society of Nephrology Terms and Conditions

6 Figure 5 Receiver-operating characteristic (ROC) curves of sensitivity plotted against 1-specificity in patients who received immunosuppressive therapy. The Youden index (sensitivity+specificity-1) identified a peak serum creatinine of ⩽4.5mg/dl as the level at which immunosuppressive therapy exerted its greatest benefit in reducing the risk for end-stage renal disease or death during the follow-up period. Kidney International  , DOI: ( /ki ) Copyright © 2011 International Society of Nephrology Terms and Conditions


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