Abstract: SA-PO640
Predictors of Renal Involvement in ANCA-Associated Vasculitis
Session Information
- Glomerular Diseases: ANCA, Anti-GBM, Kidney Biopsy
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Jayne, David R.W., University of Cambridge, Cambridge, United Kingdom
- Kronbichler, Andreas, Medical University Innsbruck, Innsbruck, Austria
- Shin, Jae Il, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
- Nakagomi, Daiki, Yamanashi University, Yamanashi, Japan
- Quintana, Luis F., Hospital Clinic de Barcelona. Fundacio Clinic per la Recerca Biomedica, Barcelona, Spain
- Busch, Martin, University Hospital Jena, Jena, Germany
- Luqmani, Raashid Ahmed, Rheumatology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- Mayer, Gert J., Medical University Innsbruck, Innsbruck, Austria
- Watts, Richard, University of East Anglia , Ipswich, United Kingdom
Background
Renal involvement in the context of anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is associated with significant morbidity and higher mortality rates. This study examined predictive factors associated of renal involvement in AAV within a large, international cross-sectional cohort.
Methods
Univariate and multivariate analyses were performed to identify risk factors associated with renal disease, which was defined as i) an increase of serum-creatinine > 30%; ii) a fall in creatinine-clearance < 25%; or iii) haematuria attributable to active vasculitis.
Results
Of the 1230 patients eligible, 723 patients (58.8%) presented with renal involvement. The majority of patients with microscopic polyangiitis (82.2%) and granulomatosis with polyangiitis (58.6%) had renal involvement, while 26.4% with eosinophilic granulomatosis with polyangiitis presented with renalvasculitis. The following clinical factors were more common among patients with renal disease that among patients without renal disease. Older age (p=0.001), fever (p<0.001), fatigue (p=0.005), weight loss (p=0.001), polyarthritis (p=0.036), petechiae/purpura (p=0.022), pulmonary haemorrhage (p=0.014), gastrointestinal symptoms (p=0.002), serum albumin below 30 g/L (p<0.001), higher CRP (p=0.038), low C3 at baseline (p=0.015), ANCA positivity (p<0.001), myeloperoxidase-ANCA (p<0.001) and proteinase 3-ANCA (p=0.020). Patients with proptosis/exophthalmos (p=0.001), saddle nose deformity (p=0.015), nasal polyps and nasal septal defect/perforation (p<0.001 each), respiratory distress/pulmonary fibrosis/asthma (p<0.001) or wheeze/obstructive airway disease (p<0.001) had a lower likelihood of developing renal involvement.
Conclusion
In this large international study, we identified clinical factors associated with renal involvement in AAV, including concomitant pulmonary alveolar haemorrhage, low C3, and elevated C-reactive protein. Further large studies arenecessary to confirm our findings.