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Updated: Oct 22, 2025

Supervised Machine Learning for Semi-Quantification of Extracellular DNA in Glomerulonephritis
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Supervised Machine Learning for Semi-Quantification of Extracellular DNA in Glomerulonephritis

Published on: June 18, 2020

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Kidney biopsy chronicity grading in antineutrophil cytoplasmic antibody-associated vasculitis

Marta Casal Moura1, Fernando C Fervenza2, Ulrich Specks1

  • 1Department of Medicine, Division of Pulmonary and Critical Care, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 26, 2021
PubMed

Insights

Chronic kidney disease changes on biopsy predict outcomes in ANCA-associated vasculitis with glomerulonephritis (AAV-GN). The Mayo Clinic Chronicity Score (MCCS) effectively predicts kidney failure and survival, aiding clinical decisions.

Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Background:

  • Kidney biopsy is crucial for prognostication in ANCA-associated vasculitis with glomerulonephritis (AAV-GN).
  • The impact of chronic histological changes on renal outcomes in AAV-GN requires further determination.

Purpose of the Study:

  • To validate and evaluate the Mayo Clinic Chronicity Score (MCCS) for outcome prediction in AAV-GN.
  • To assess the independent predictive value of chronic kidney changes on renal function and survival.

Main Methods:

  • Retrospective cohort study of 329 myeloperoxidase (MPO)- or proteinase 3 (PR3)-ANCA-positive patients with AAV and active renal disease.
  • Application and validation of the Mayo Clinic Chronicity Score (MCCS) using kidney biopsy data.
  • Analysis of correlations between MCCS grades, renal function (eGFR), and clinical outcomes (kidney failure, death).

Main Results:

  • MCCS grades significantly correlated with impaired renal function at presentation (P < 0.0001).
  • Higher MCCS scores were associated with lower eGFR, reduced renal recovery, and increased risk of kidney failure and death (P < 0.0001).
  • MCCS effectively stratified renal outcomes and identified a cutoff (MCCS ≥4) for kidney failure prediction.

Conclusions:

  • Chronic changes on kidney histology independently predict renal function, outcomes, and treatment response in AAV-GN.
  • The MCCS is a valuable tool for prognostic assessment and clinical decision-making in AAV-GN.
  • Histological chronicity assessment aids in predicting kidney failure risk.
Abstract

Keywords:
ANCAMayo Clinic Chronicity Scoreglomerulonephritiskidney biopsy

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