1
|
Dong J, Huang L, Li C, Wu B, Yang X, Ge Y. Clinical efficacy of centrifugal-membranous hybrid double filtration plasmapheresis and membranous double filtration plasmapheresis on severe lupus nephritis. Lupus 2023:9612033231187229. [PMID: 37487569 DOI: 10.1177/09612033231187229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE The study delves into the clinical efficacy and safety of centrifugal-membranous hybrid double filtration plasmapheresis (C/M hybrid DFPP) on severe lupus nephritis (LN) by comparing it with membranous DFPP (M DFPP). METHODS A retrospective cohort study was conducted in 70 patients who were diagnosed with severe LN and had received DFPP treatment. RESULTS A total of 181 DFPPs were performed, including 133 C/M hybrid DFPPs (51 patients) and 48 M DFPPs (19 patients).The ANA, A-dsDNA titer, quantitative urinary protein, and serum creatinine decreased significantly and hemoglobin increased significantly after the DFPP treatment and at third month after treatment. Two patients in the M DFPP group developed bleeding complications, and four patients in the C/M hybrid DFPP group developed perioral numbness. CONCLUSION Although there was no significant difference in clinical efficacy between C/M hybrid DFPP and M DFPP on severe LN, the risk of bleeding complications was significantly lower in the C/M hybrid DFPP group.
Collapse
Affiliation(s)
- Jianhua Dong
- National Clinical Research Center of kidney Diseases, JinLing Hospital, Nanjing University School of medicine, Nanjing, China
| | - Li Huang
- National Clinical Research Center of kidney Diseases, JinLing Hospital, Nanjing University School of medicine, Nanjing, China
| | - Chuan Li
- National Clinical Research Center of kidney Diseases, JinLing Hospital, Nanjing University School of medicine, Nanjing, China
| | - Bian Wu
- National Clinical Research Center of kidney Diseases, JinLing Hospital, Nanjing University School of medicine, Nanjing, China
| | - Xi Yang
- National Clinical Research Center of kidney Diseases, JinLing Hospital, Nanjing University School of medicine, Nanjing, China
| | - Yongchun Ge
- National Clinical Research Center of kidney Diseases, JinLing Hospital, Nanjing University School of medicine, Nanjing, China
| |
Collapse
|
2
|
Scholkmann F, Tsenkova R. Changes in Water Properties in Human Tissue after Double Filtration Plasmapheresis-A Case Study. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27123947. [PMID: 35745071 PMCID: PMC9230951 DOI: 10.3390/molecules27123947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
Double-filtration plasmapheresis (DFPP) is a blood cleaning technique that enables the removal of unwanted substances from the blood. In our case study, we performed near-infrared (NIR) spectroscopy measurements on the human hand tissue before and after a specific DFPP treatment (INUSpheresis with a TKM58 filter), along with NIR measurements of the substances extracted via DFPP (eluate). The spectral data were analyzed using the aquaphotomics approach. The analysis showed that the water properties in the tissue change after DFPP treatment, i.e., an increase in small water clusters, free water molecules and a decrease in hydroxylated water as well as superoxide in hydration shells was noted. The opposite effect was observed in the eluates of both DFPP treatments. Our study is the first that documents changes in water spectral properties after DFPP treatments in human tissue. The changes in tissue water demonstrated by our case study suggest that the positive physiological effects of DFPP in general, and of INUSpheresis with the TKM58 filter in particular, may be associated with improvements in water quality in blood and tissues.
Collapse
Affiliation(s)
- Felix Scholkmann
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-255-93-26
| | - Roumiana Tsenkova
- Aquaphotomics Research Department, Graduate School of Agricultural Science, Kobe University, Kobe 657-8501, Japan;
| |
Collapse
|
3
|
Bagir GS, Bakiner OS, Haydardedeoglu FE, Araz F, Ertorer ME, Kozanoglu İ. Effect of type 2 diabetes mellitus on efficacy and safety of therapeutic apheresis for severe hypertriglyceridemia. Ther Apher Dial 2020; 25:681-686. [PMID: 33098371 DOI: 10.1111/1744-9987.13603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/16/2020] [Accepted: 10/21/2020] [Indexed: 12/25/2022]
Abstract
The efficacy and safety of triglyceride (TG) apheresis in patients with type 2 diabetes mellitus (DM) is unclear. Diabetic complications may predispose patients to adverse events (AEs) associated with the apheresis procedure, and diabetic dyslipidemia may negatively affect the efficacy of therapeutic apheresis (TA). We investigated the effect of DM on the efficacy and complications of TA. Patients with severe hypertriglyceridemia who underwent apheresis for treatment or for the prevention of acute pancreatitis were included in this retrospective study. Epidemiological data, lipid parameters, and AEs were recorded before and after each therapeutic session. A total of 166 procedures were performed in 27 patients. Group 1 included 17 patients with type 2 DM, and Group 2 included 10 patients without DM. The mean percentage decrease in TG levels (TG%) was higher in Group 1 (71.9% vs 60.6%, P < .001). The TG% was negatively correlated with the duration of DM in Group 1 (r = -.49, P < .001). The total number of TA sessions was 142 in patients who underwent double filtration plasmapheresis and 24 in patients who underwent therapeutic plasma exchange. We observed 9 (5.4%) mild-to-moderate AEs. No intergroup difference was observed in the total number of AEs (P = .06). TA is safe and effective in patients with type 2 DM with severe hypertriglyceridemia.
Collapse
Affiliation(s)
- Gulay Simsek Bagir
- Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Adana, Turkey
| | - Okan Sefa Bakiner
- Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Adana, Turkey
| | - Filiz Eksi Haydardedeoglu
- Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Adana, Turkey
| | - Filiz Araz
- Department of Gastroenterology, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Adana, Turkey
| | - Melek Eda Ertorer
- Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Adana, Turkey
| | - İlknur Kozanoglu
- Department of Physiology, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Apheresis Unit, Adana, Turkey
| |
Collapse
|
4
|
Al Hamzi HA, Al-Mayouf SM, Al Shaikh AA, Al-Sheikh HA, Alshomar AA, Al Humaidan HA, Al Dalaan AN, Al Saleh SS. Early and late effects of therapeutic plasma exchange in patients with systemic lupus erythematosus and antineutrophil cytoplasmic antibody-associated vasculitis: A single-center experience. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2019; 30:775-780. [PMID: 31464233 DOI: 10.4103/1319-2442.265452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Therapeutic plasma exchanges (TPE) is considered as one of the treatment modalities that is used in systemic autoimmune diseases. This study aimed to describe the early and late effect of TPE in patients with systemic lupus erythematosus (SLE) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) presented with acute kidney injury (AKI). Retrospective study comprised patients with SLE and AAV with AKI seen between January 2000 and June 2014 at King Faisal Specialist Hospital and Research Center in Riyadh. All patients underwent TPE. Retrospectively, all patients were assessed for early and late renal outcome at 12- month and 24-month intervals. Renal outcome was assessed according to serum creatinine level, glomerular filtration rate, active urine sediment, and proteinuria. P <0.05 was considered significant. A total of 68 patients were included, 58 patients (51 females) had SLE and 10 patients (7 females) had AAV completed TPE. All patients had active disease and had AKI. At the first 12 months, 18 patients (17 SLE and 1 AAV) showed complete response and 14 patients had partial response while 22 patients did not show therapeutic benefit. The nonresponders (22 patients) entered the late assessment interval (24 months) without any therapeutic response. Statistically, there was no significant difference between the patient's response to TPE at the first and second assessment intervals and the baseline serum creatinine level. TPE might be an alternative rescue treatment in lupus nephritis with AKI.
Collapse
Affiliation(s)
- Hanan A Al Hamzi
- Department of Medicine, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Sulaiman M Al-Mayouf
- Department of Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmad A Al Shaikh
- Adult Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Haifa A Al-Sheikh
- Adult Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmad A Alshomar
- Adult Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hind A Al Humaidan
- Blood Bank and Transfusion Services; Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdullah N Al Dalaan
- Adult Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Salman S Al Saleh
- Adult Rheumatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Nishida R, Kaneko S, Usui J, Kawamura T, Tsunoda R, Tawara T, Fujita A, Nagai K, Kai H, Morito N, Saito C, Yamagata K. Plasma Exchange Is Highly Effective for Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Patients With Rapidly Progressive Glomerulonephritis Who Have Advanced to Dialysis Dependence: A Single-Center Case Series. Ther Apher Dial 2019; 23:253-260. [PMID: 31033151 DOI: 10.1111/1744-9987.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 02/20/2019] [Indexed: 11/28/2022]
Abstract
Plasma exchange (PEX) can be an effective treatment in anti-neutrophil cytoplasmic antibody-associated vasculitis with severe renal damage; however, it is still controversial. Among cases of newly diagnosed AAV with rapidly progressive glomerulonephritis at our department from 2008 onward, 11 patients who received PEX (seven cases for severe renal damage [R-PEX] and four cases for lung hemorrhage [L-PEX]) were retrospectively analyzed. All cases of R-PEX were dependent on hemodialysis at the beginning of PEX and all received seven sessions of PEX (50 mL/kg or 1.3 plasma volume per exchange) within 2 weeks. All cases became dialysis-independent within 8 weeks, with 3- and 12-month cumulative renal survival rates of 100% and 80%, respectively. All cases of L-PEX retained their renal function. In rapidly developing, newly dialysis-dependent antibody-associated vasculitis with rapidly progressive glomerulonephritis patients with normal renal function before disease onset, standard PEX can be expected to induce sufficient renal recovery to establish dialysis independence.
Collapse
Affiliation(s)
- Reimi Nishida
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shuzo Kaneko
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Joichi Usui
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuya Kawamura
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ryoya Tsunoda
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takashi Tawara
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akiko Fujita
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kei Nagai
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hirayasu Kai
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Naoki Morito
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Chie Saito
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kunihiro Yamagata
- Department of Nephrology and Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| |
Collapse
|
6
|
Hong Y, Shi P, Liu X, Yang L, Li K, Xu F, Liang S, Liu Z, Zhang H, Chen Y, Hu W. Distinction between MPO-ANCA and PR3-ANCA-associated glomerulonephritis in Chinese patients: a retrospective single-center study. Clin Rheumatol 2019; 38:1665-1673. [PMID: 30737591 DOI: 10.1007/s10067-019-04458-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/28/2018] [Accepted: 01/28/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To retrospectively investigate the clinical and histological features and outcomes of ANCA-associated glomerulonephritis (AAGN) with different ANCA serotypes. METHOD A total of 467 AAGN patients were divided into MPO-AAGN (MPO) and PR3-AAGN (PR3) groups according to ANCA serotype. Clinical and histological features and renal outcomes were compared. RESULTS In this study, 429 (91.9%) patients tested positive for MPO-ANCA, and 38 (8.1%) for PR3-ANCA. The median age at diagnosis (P = 0.017) and proportion of females (P = 0.003) were higher in the MPO group. Joint (P < 0.001), ENT (P = 0.000), skin (P = 0.007), and eye (P = 0.014) involvements were more common in the PR3 group. Compared with that in the PR3-group, a higher proportion of patients in the MPO group had microscopic polyangiitis (P = 0.000), and a lower proportion of exhibited granulomatosis with polyangiitis (P = 0.000). Patients in the MPO group also exhibited lower BVAS scores (P = 0.003) and higher serum albumin levels (P = 0.009). Histologically, a lower proportion of MPO patients had crescentic glomerulonephritis (P = 0.028) and acute tubule-interstitial lesion scores (P = 0.007), but a higher proportion of these patients exhibited mixed class glomerulonephritis (P = 0.032) than in the PR3 group. The relapse rate was lower (P = 0.020), and the 5-year relapse-free survival rate (P = 0.003) was higher in the MPO group than in the PR3 group. However, the 5-year renal survival rates (P = 0.106) were not significantly different. CONCLUSIONS MPO-ANCA was predominant in Chinese patients with ANCA-associated vasculitis and renal disease. The epidemiological characteristics, extra-renal involvement, and histopathological classes and outcomes were different between MPO-positive and PR3-positive patients, implying that they might be two different disease entities.
Collapse
Affiliation(s)
- Yan Hong
- Jinling Clinical Medical College of Nanjing Medical University, Nanjing, China.,The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, China
| | - Pengxian Shi
- Jinling Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Xia Liu
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Liu Yang
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Kang Li
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Feng Xu
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Shaoshan Liang
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Zhengzhao Liu
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Haitao Zhang
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Yinghua Chen
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
| | - Weixin Hu
- Jinling Clinical Medical College of Nanjing Medical University, Nanjing, China. .,National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
| |
Collapse
|
7
|
Yu X, Zhang L, Wang L, Lu W, Sun F, Xu P, Lan G. MRI assessment of erosion repair in patients with long-standing rheumatoid arthritis receiving double-filtration plasmapheresis in addition to leflunomide and methotrexate: a randomized controlled trial. Clin Rheumatol 2018; 37:917-925. [DOI: 10.1007/s10067-017-3956-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/24/2017] [Accepted: 12/12/2017] [Indexed: 12/31/2022]
|
8
|
Boser M, Kielstein JT. [Role of plasmapheresis and immunoadsorption in salvage therapy of rheumatological diseases]. Z Rheumatol 2017; 75:964-972. [PMID: 27807630 DOI: 10.1007/s00393-016-0219-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Many rheumatological diseases are either caused by specific known proteins, such as antibodies or mediated by a plethora of cytokines. Both the unspecific immunosuppressive therapy and the specific action of biologics usually require time to be effective; therefore, extracorporeal forms of treatment are increasingly being employed in severe forms of rheumatological diseases as well as in patients who cannot tolerate pharmacological treatment or where the risk of pharmacological treatment may outweigh the potential benefits. Therapeutic plasma exchange (TPE) removes not only pathogenic substances, such as autoantibodies, lipoproteins and circulating immune complexes from the plasma but also cytokines. The removed plasma that is discarded has to be substituted by blood products, e.g. human albumin or fresh frozen plasma. Fresh frozen plasma is always used when missing plasma components must be replenished, such as ADAMTS-13 in thrombotic thrombocytopenic purpura (TTP). The separated plasma can be further processed by pumping into a hollow fiber filter (cut-off of ~700 kD) and in this way low-density lipoprotein cholesterol and IgM can be eliminated. This treatment mode, called cascade filtration is used to treat diseases, such as Waldenström's macroglobulinemia and cryoglobulinemia. A specific way to remove antibodies is by immunoadsorption in which the antibodies are specifically removed by an adsorber. For this procedure there is no need to substitute blood products. This review article describes the principles of the two different treatment methods, the advantages and disadvantages and also summarizes the current evidence for their use in rheumatological diseases.
Collapse
Affiliation(s)
- M Boser
- Medizinische Klinik V, Städtisches Klinikum Braunschweig, Salzdahlumer Str. 90, 38126, Braunschweig, Deutschland
| | - J T Kielstein
- Medizinische Klinik V, Städtisches Klinikum Braunschweig, Salzdahlumer Str. 90, 38126, Braunschweig, Deutschland.
| |
Collapse
|
9
|
Chen Y, Bao H, Liu Z, Liu X, Gao E, Zeng C, Zhang H, Liu Z, Hu W. Risk Factors for Renal Survival in Chinese Patients with Myeloperoxidase-ANCA-Associated GN. Clin J Am Soc Nephrol 2017; 12:417-425. [PMID: 28148558 PMCID: PMC5338707 DOI: 10.2215/cjn.06200616] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 12/05/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Our study explored the association of histopathologic classification of ANCA-associated GN with renal survival in Chinese patients with myeloperoxidase-ANCA-associated GN. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Two hundred fifteen patients with biopsy-proven myeloperoxidase-ANCA-associated GN were included from January of 1996 to December of 2014. The biopsies included focal (n=27), mixed (n=82), crescentic (n=47), and sclerotic (n=59) classes. The long-term renal outcome and risk factors of myeloperoxidase-ANCA-associated GN for different histopathologic classes were retrospectively analyzed. RESULTS During a median follow-up time of 22 (9-51) months, 88 (40.9%) patients reached ESRD. The 5-year renal survival (overall 58.7%) was highest in the focal class (100.0%) and lowest in the sclerotic class (20.7%), with no difference between the mixed (58.9%) and crescentic (67.4%) classes. Patients in the mixed (hazard ratio, 0.34; 95% confidence interval, 0.20 to 0.57; P<0.001) and crescentic (hazard ratio, 0.31; 95% confidence interval, 0.16 to 0.59; P<0.001) classes were at lower risk for ESRD compared with patients in the sclerotic class, as were patients who received glucocorticoids plus mycophenolate mofetil (hazard ratio, 0.32; 95% confidence interval, 0.18 to 0.60; P<0.001) compared with those receiving glucocorticoids alone. In addition, patients with a serum creatinine level ≥4 mg/dl (hazard ratio, 2.93; 95% confidence interval, 1.77 to 4.85; P<0.001) or hypoalbuminemia (hazard ratio, 2.11; 95% confidence interval, 1.32 to 3.34; P=0.002) were at higher risk for ESRD. A serum creatinine level ≥4 mg/dl and a percentage of global sclerotic glomeruli ≥60% were the two independent risk factors for ESRD in the sclerotic class. CONCLUSIONS The histopathologic classification of ANCA-associated GN in combination with serum creatinine and serum albumin levels and treatment regimen is associated with renal outcome in myeloperoxidase-ANCA-associated GN. The evaluation of serum creatinine level and percentage of global sclerotic glomeruli provides additional information on the risk of renal survival in the sclerotic class of myeloperoxidase-ANCA-associated GN.
Collapse
Affiliation(s)
- Yinghua Chen
- National Clinical Research Centre of Kidney Diseases, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | | | | | | | | | | | | | | | | |
Collapse
|