#6879 association of the berden classification and the prognosis of anca vasculitis

Abstract Background and Aims ANCA-associated vasculitides (AAVs) are systemic diseases characterized by inflammatory involvement of the small vessel wall, and renal involvement is frequent and severe. The new Berden histo-pathological classification established in 2010 has made it possible to classify ANCA-associated glomerulonephritis (GAA) into focal, mixed, cellular, and sclerotic forms in order to better guide the therapeutic management and to assess the prognosis. The aim of this work was to evaluate the prognostic value of this anatomopathological classification. Method We conducted a single-center retrospective descriptive and analytical study of patients diagnosed with histologically confirmed GAA in our Nephrology Department during the period from 2016 to 2022. Results We collected 20 patients, median age 52 years [21-77 years]. The sex ratio (M/F) was 0.8. Histological confirmation of GAA was based on renal biopsies in 100% of cases. Rapidly progressive glomerulonephritis was the nephrological presentation in 15 patients. One patient had no hematuria and one had no proteinuria and renal failure was present in all cases. Good Pasture syndrome was present in 7 cases. The Berden classification was applied to the 20 renal biopsies: the focal form (2 cases), the cellular form (7 cases), the mixed form (7 cases) and the sclerotic form (4 cases). The evolution was marked by a partial remission for 11 patients. After an evolution of 1 year, end-stage renal failure (ESRD) was retained in 13 patients. The sclerotic form was not associated with a poor prognosis in our population (p = 0.642). Conclusion Of course, our sample size was small and in our population we found a predominance of the mixed and cellular forms compared to the sclerotic form, contrasting with poor therapy with a rapid evolution towards CKD.