Kidney Week

Abstract: SA-PO642

Venous Thromboembolisms in ANCA-Associated Vasculitis: Incidence and Risk Factors

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

• Isaacs, Brad, Johns Hopkins School of Medicine, Baltimore, Maryland, United States

Brad Isaacs,

• Seo, Philip, Johns Hopkins School of Medicine, Baltimore, Maryland, United States

Philip Seo,

• Gapud, Eric J., Johns Hopkins School of Medicine, Baltimore, Maryland, United States

Eric J. Gapud,

• Antiochos, Brendan, Johns Hopkins School of Medicine, Baltimore, Maryland, United States

Brendan Antiochos,

• Geetha, Duvuru, John Hopkins Bayview Medical Center, Baltimore, Maryland, United States

Duvuru Geetha,

Background

The incidence of venous thromboembolism (VTE) is increased in ANCA associated vasculitis (AAV). We aimed to assess the frequency of VTEs observed in our center and identify risk factors.

Methods

VTEs in 155 AAV patients with diagnosed Granulomatosis with Polyangiitis and Microscopic Polyangiitis were analyzed. Baseline demographics, clinical and serologic data were extracted. Univariate and multivariate analyses were performed to identify factors associated with VTE in AAV.

Results

Of the 155 AAV patients, the mean age was 55.1 ± 17.5 years, 61% females, 55% PR3-ANCA positive, 45% MPO-ANCA, with a total mean BMI of 28.9 ± 6.3 kg/m². The mean Birmingham Vasculitis Activity Score (BVAS) was 14.3 ± 6.0. VTEs occurred in 21 (14%) patients and the mean time to VTE was 1.8 months. Univariate analyses identified PR3-ANCA as significantly associated with the onset of VTE (17/85, p=0.02). In multivariate models, each adjusted for age, sex, hyperlipidemia/hypertension medications, smoking status, diagnosis (GPA/MPA), the associations of PR3-ANCA (p=0.018), BMI (p=0.0015), and RPGN (p=0.015) with VTE incidence remained significant, while there was no statistically significant correlation of alveolar hemorrhage or BVAS severity with VTE.

Conclusion

The incidence of VTE in AAV was 21/155 (14%). PR3-ANCA, RPGN, and increased BMI are risk factors for developing VTEs. BVAS severity or alveolar hemorrhage does not increase risk of venous thromboembolic events. Further studies are needed to confirm these findings.

BMI (kg/m²), ANCA serology (PR3 vs MPO), RPGN are significantly correlated with incidence of venous thromboembolisms. BVAS severity and presence of alveolar hemorrhage do not appear to contribute to VTE risk.