Xuejing Wang : Kidney Dysfunction in NMOSD: Relapse Risk & Prognosis

A recent study conducted at the First Affiliated Hospital of Zhengzhou University has shed light on kidney dysfunction in patients with aquaporin-4 (AQP4)-IgG-seropositive neuromyelitis optica spectrum disorder (NMOSD). The findings revealed that these patients exhibit glomerular hyperfiltration and impaired urine concentrating ability, which may pose a risk factor for relapse and poor clinical prognosis.

### Study Details
The retrospective cohort study included 327 patients with AQP4-IgG-seropositive NMOSD, 313 patients with multiple sclerosis (MS), and 526 healthy controls (HCs). Patients underwent kidney function testing and routine urine examinations between 2016 and 2020. The study found that patients with AQP4-IgG-seropositive NMOSD had significantly higher glomerular filtration rates (eGFR) compared to those with MS and HCs.

### Key Findings
Led by senior investigator Xuejing Wang, the study aimed to explore the association of eGFR with the incidence of relapse and clinical prognosis in NMOSD. Results showed that higher eGFR was linked to an increased risk of relapse, with the highest risk observed in patients with eGFR greater than 160 mL/min. Additionally, urine pH was significantly higher in NMOSD patients compared to those with MS and HCs.

### Implications
Over a median follow-up of 3.1 years, the study identified an overall poor clinical prognosis incidence rate of 51.9%. Univariate analyses revealed that eGFR, sex, depression, and initial EDSS score were significantly associated with poor clinical prognosis. Notably, eGFR remained an independent risk factor even after adjusting for other variables.

### Limitations
The study acknowledged limitations such as changes in kidney function over time and the lack of information on lifestyle factors. However, the findings provide valuable insights into the impact of AQP4-IgG on peripheral organs and highlight the importance of monitoring kidney function in NMOSD patients.

In conclusion, the study underscores the potential role of kidney dysfunction as a predictor of relapse and poor clinical prognosis in AQP4-IgG-seropositive NMOSD. The researchers hope that these findings will contribute to a better understanding of the disease and emphasize the importance of routine kidney function testing in these patients.

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