DIFFERENCES BETWEEN ANTI-MYELOPEROXIDASE-3-ASSOCIATED AND ANTIPROTEINASE-3-ASSOCIATED RENAL-DISEASE

We performed a retrospective study of the clinical features, the patte rn of the pre-treatment renal function loss, the renal morphology and the outcome in 92 patients with anti-neutrophil cytoplasmic autoantibo dies directed against proteinase 3 (aPR3; N = 46) or myeloperoxidase ( aMPO; N = 46). Patients with aMPO had a higher median age than patient s with aPR3 (63 and 56 years; P < 0.05). The mean (+/-SD) number of af fected organs in the aPR3 group exceeded that of the aMPO group (3.9 /- 1.4 and 2.2 +/- 1.1; P < 0.01). The prevalence of renal involvement did not differ between patients with aPR3 and aMPO (83% and 67%, resp ectively; NS). Pre-treatment renal function deteriorated significantly faster in aPR3- than in aMPO-associated renal disease. The kidney bio psies from patients with aPR3 showed a higher activity index (10.2 +/- 3.8 and 7.3 +/- 3.2; P < 0.03) and a lower chronicity index (4.5 +/- 2.6 and 7.0 +/- 3.1; P < 0.02) than biopsies from patients with aMPO. The kidney survival at two years was 73% in patients with aPR3- and 61 % in patients with aMPO-associated renal disease (NS). We conclude tha t renal function generally deteriorates faster in aPR3- than in aMPO-a ssociated renal disease. This goes together with more active renal les ions in patients with aPR3 and more chronic renal lesions in patients with aMPO. Despite these differences, there is no difference in outcom es between both antibody groups.