{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:22:21Z","timestamp":1792628541100,"version":"4.5.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,2]]},"abstract":"\n Background and objectives<\/jats:title>\n The significance of persistent hematuria or proteinuria in patients with ANCA-associated vasculitis who are otherwise in clinical remission is unclear.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n \n A\n post hoc<\/jats:italic>\n analysis was conducted using participants enrolled in two randomized, placebo-controlled clinical trials who had active GN due to ANCA-associated vasculitis, had positive ANCA, and achieved remission by month 6. Dipstick and microscopic urinalyses were performed at each visit. Persistent hematuria or proteinuria for at least 6 months and the cumulative duration of hematuria were examined. Renal relapse was defined as new or worsening red blood cell casts and\/or worsening kidney function according to the Birmingham Vasculitis Activity Score for Granulomatosis with Polyangiitis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were 149 patients included in this study: 42% had persistent hematuria, and 43% had persistent proteinuria beyond 6 months. Persistent hematuria was associated with a significantly higher risk of relapse, even after adjusting for potential confounders (subdistribution hazard ratio, 3.99; 95% confidence interval, 1.20 to 13.25;\n P<\/jats:italic>\n =0.02); persistent proteinuria was not associated with renal relapse (subdistribution hazard ratio, 1.44; 95% confidence interval, 0.47 to 4.42;\n P<\/jats:italic>\n =0.53). Furthermore, greater cumulative duration of hematuria was significantly associated with a higher risk of renal relapse (adjusted subdistribution hazard ratio, 1.08 per each month; 95% confidence interval, 1.03 to 1.12;\n P<\/jats:italic>\n <0.01). The median time to renal relapse was 22 months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In patients with ANCA-associated vasculitis and kidney involvement who achieve remission after induction therapy, the presence of persistent hematuria, but not proteinuria, is a significant predictor of future renal relapse.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.04160417","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T20:20:11Z","timestamp":1516911611000},"page":"251-257","source":"Crossref","is-referenced-by-count":69,"title":["The Utility of Urinalysis in Determining the Risk of Renal Relapse in ANCA-Associated Vasculitis"],"prefix":"10.2215","volume":"13","author":[{"given":"Rennie L.","family":"Rhee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linna","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando C.","family":"Fervenza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary S.","family":"Hoffman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cees G.M.","family":"Kallenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Langford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Joseph","family":"McCune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Monach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Spiera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. William","family":"St. Clair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Specks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Merkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,1,25]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/S0272-6386(03)00025-8","article-title":"Outcome of ANCA-associated renal vasculitis: A 5-year retrospective study.","volume":"41","author":"Booth","year":"2003","journal-title":"Am J Kidney Dis"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1136\/ard.2010.137778","article-title":"Long-term patient survival in ANCA-associated vasculitis.","volume":"70","author":"Flossmann","year":"2011","journal-title":"Ann Rheum Dis"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1681\/ASN.V82314","article-title":"ANCA small-vessel vasculitis.","volume":"8","author":"Falk","year":"1997","journal-title":"J Am Soc Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1097\/MD.0b013e3181c101cc","article-title":"Persistent hematuria after induction of remission in Wegener granulomatosis: A therapeutic dilemma.","volume":"88","author":"Magrey","year":"2009","journal-title":"Medicine (Baltimore)"},{"key":"B5-20230813","first-page":"284","article-title":"Level of red blood cells in the urinary sediment reflects the degree of renal activity in Wegener\u2019s granulomatosis.","volume":"50","author":"Fujita","year":"1998","journal-title":"Clin Nephrol"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.3899\/jrheum.111608","article-title":"Persistent or new onset microscopic hematuria in patients with small vessel vasculitis in remission: Findings on renal biopsy.","volume":"39","author":"Geetha","year":"2012","journal-title":"J Rheumatol"},{"key":"B7-20230813","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.semarthrit.2014.03.008","article-title":"Hematuria duration does not predict kidney function at 1 year in ANCA-associated glomerulonephritis.","volume":"44","author":"Chen","year":"2014","journal-title":"Semin Arthritis Rheum"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1056\/NEJMoa0909905","article-title":"Rituximab versus cyclophosphamide for ANCA-associated vasculitis.","volume":"363","author":"Stone","year":"2010","journal-title":"N Engl J Med"},{"key":"B9-20230813","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1056\/NEJMoa041884","article-title":"Etanercept plus standard therapy for Wegener\u2019s Granulomatosis.","volume":"352","year":"2005","journal-title":"N Engl J Med"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1002\/art.39637","article-title":"Factors determining the clinical utility of serial measurements of antineutrophil cytoplasmic antibodies targeting proteinase 3.","volume":"68","author":"Fussner","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"B11-20230813","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1002\/1529-0131(200104)44:4<912::AID-ANR148>3.0.CO;2-5","article-title":"A disease-specific activity index for Wegener\u2019s granulomatosis: Modification of the Birmingham Vasculitis Activity Score.","volume":"44","author":"Stone","year":"2001","journal-title":"Arthritis Rheum"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/art.1780370206","article-title":"Nomenclature of systemic vasculitides. 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