Title :

Clinical and Prognostic Factors in Patients with IgG4-Related Kidney Disease.

Author(s) :

Chaba, Anis [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Devresse, Arnaud [Auteur]
Cliniques Universitaires Saint-Luc [Bruxelles]
Audard, Vincent [Auteur]
Hôpital Henri Mondor
Institut Mondor de Recherche Biomédicale [IMRB]
Boffa, Jean-Jacques [Auteur]
CHU Tenon [AP-HP]
Boffa, Jean-Jacques [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Cartery, Claire [Auteur]
Centre hospitalier [Valenciennes, Nord]
Deltombe, Clément [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Chemouny, Jonathan [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Contamin, Claudine [Auteur]
Groupe Hospitalier Mutualiste [Grenoble] [GHM]
Courivaud, Cecile [Auteur]
Hôpital JeanMinjoz
Duquennoy, Simon [Auteur]
Garcia, Hugo [Auteur]
Sorbonne Université - Faculté de Santé [SU FdS]
Joly, Dominique [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Goumri, Nabila [Auteur]
Hôpitaux de Chartres [Chartres]
Hanouna, Guillaume [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Halimi, Jean-Michel [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Plaisier, Emmanuelle [Auteur]
AURA Paris - Plaisance
Hamidou, Mohamed [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Landron, Cédric [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Launay, David [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Lebas, Céline [Auteur]
Centre hospitalier [Valenciennes, Nord]
Legendre, Mathieu [Auteur]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Masseau, Agathe [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Mathian, Alexis [Auteur]
Hôpital Cochin [AP-HP]
Mercadal, Lucile [Auteur]
Sorbonne Université - Faculté de Santé [SU FdS]
Morel, Nathalie [Auteur]
Hôpital Cochin [AP-HP]
Mutinelli-Szymanski, Prisca [Auteur]
CHU Trousseau [Tours]
Palat, Sylvain [Auteur]
CHU Limoges
Pennaforte, Jean-Loup [Auteur]
Hôpital universitaire Robert Debré [Reims] [CHU Reims]
Peraldi, Marie-Noelle [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Pozdzik, Agnieszka [Auteur]
Centre Hospitalier Universitaire Brugmann [Bruxelles] [CHU]
Schleinitz, Nicolas [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Thaunat, Olivier [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Titeca-Beauport, Dimitri [Auteur]
CHU Amiens-Picardie
Mussini, Charlotte [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Touati, Sonia [Auteur]
Centre Hospitalier René Dubos [Pontoise]
Prinz, Eric [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Faller, Anne-Laure [Auteur]
Clinique Sainte Anne [Strasbourg]
Richter, Sarah [Auteur]
Clinique Sainte Anne [Strasbourg]
Vilaine, Eve [Auteur]
Hôpital Ambroise Paré [AP-HP]
Ferlicot, Sophie [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Von-Kotze, Clarissa [Auteur]
Hôpital de la Conception [CHU - APHM] [LA CONCEPTION]
Belliere, Julie [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Olagne, Jerome [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Mesbah, Rafik [Auteur]
Centre Hospitalier Boulogne-sur-mer
Snanoudj, Renaud [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Nouvier, Mathilde [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Ebbo, Mikael [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Zaidan, Mohamad [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]

Journal title :

Clinical Journal of the American Society of Nephrology

Abbreviated title :

Clin J Am Soc Nephrol

Publication date :

2023-06-08

ISSN :

1555-905X

English keyword(s) :

interstitial fibrosis
clinical nephrology
clinical immunology
chronic nephropathy
CKD

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background IgG4-related kidney disease is a major manifestation of IgG4-related disease, a systemic fibroinflammatory disorder. However, the clinical and prognostic kidney-related factors in patients with IgG4-related ...
Show more >Background IgG4-related kidney disease is a major manifestation of IgG4-related disease, a systemic fibroinflammatory disorder. However, the clinical and prognostic kidney-related factors in patients with IgG4-related kidney disease are insufficiently defined. Methods We conducted an observational cohort study using data from 35 sites in two European countries. Clinical, biologic, imaging, and histopathologic data; treatment modalities; and outcomes were collected from medical records. Logistic regression was performed to identify the possible factors related to an eGFR ≤30 ml/min per 1.73 m 2 at the last follow-up. Cox proportional hazards model was performed to assess the factors associated with the risk of relapse. Results We studied 101 adult patients with IgG4-related disease with a median follow-up of 24 (11–58) months. Of these, 87 (86%) patients were male, and the median age was 68 (57–76) years. Eighty-three (82%) patients had IgG4-related kidney disease confirmed by kidney biopsy, with all biopsies showing tubulointerstitial involvement and 16 showing glomerular lesions. Ninety (89%) patients were treated with corticosteroids, and 18 (18%) patients received rituximab as first-line therapy. At the last follow-up, the eGFR was below 30 ml/min per 1.73 m 2 in 32% of patients; 34 (34%) patients experienced a relapse, while 12 (13%) patients had died. By Cox survival analysis, the number of organs involved (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.01 to 1.55) and low C3 and C4 concentrations (HR, 2.31; 95% CI, 1.10 to 4.85) were independently associated with a higher risk of relapse, whereas first-line therapy with rituximab was protective (HR, 0.22; 95% CI, 0.06 to 0.78). At their last follow-up, 19 (19%) patients had an eGFR ≤30 ml/min per 1.73 m 2 . Age (odd ratio [OR], 1.11; 95% CI, 1.03 to 1.20), peak serum creatinine (OR, 2.74; 95% CI, 1.71 to 5.47), and serum IgG4 level ≥5 g/L (OR, 4.46; 95% CI, 1.23 to 19.40) were independently predictive for severe CKD. Conclusions IgG4-related kidney disease predominantly affected middle-aged men and manifested as tubulointerstitial nephritis with potential glomerular involvement. Complement consumption and the number of organs involved were associated with a higher relapse rate, whereas first-line therapy with rituximab was associated with lower relapse rate. Patients with high serum IgG4 concentrations (≥5 g/L) had more severe kidney disease.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T22:33:32Z
2024-03-27T14:36:03Z