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Abstract: PO1620

Renal Survival in Anti-Glomerular Basement Membrane Disease

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Floyd, Lauren, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
  • Li, Anna S., The University of Manchester Faculty of Biology Medicine and Health, Manchester, Manchester, United Kingdom
  • Brown, Nina, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
  • Alderson, Helen, Salford Royal NHS Foundation Trust, Salford, Salford, United Kingdom
  • Brix, Silke R., The University of Manchester Faculty of Biology Medicine and Health, Manchester, Manchester, United Kingdom
  • Dhaygude, Ajay Prabhakar, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
Background

Anti-glomerular basement membrane (GBM) vasculitis is a rare immune mediated kidney disease. Presentation with severe kidney dysfunction in need of renal replacement therapy (RRT) often results in end stage kidney disease (ESKD). Reliable predictors of kidney survival are needed.

Methods

Retrospective analysis of patients with anti-GBM disease from the North West of England.

Results

Seventy patients with GBM nephritis were identified, 20 patients presented double positive for anti-neutrophil cytoplasmic (ANCA) and GBM antibodies (28.57%). Median age was 64 years (Interquartile range 43 – 76 years). 39 patients were female (55.7%). Median kidney function at presentation was an estimated glomerular filtration rate of 593 ml/min (eGFR, IQR 419.75 – 835.75 ml/min). Sixty patients required RRT at presentation, and twelve of these patients recovered sufficient kidney function to withdraw RRT (25.5%). Median follow up was 41 months (IQR 11 - 77.5), and during follow up two additional patients developed ESKD (n = 50). The median presenting eGFR was numerically higher but not significantly different in patients that required dialysis initially and recovered residual function compared to patients that remained dialysis dependent, and no cut-off was detected (p=0.25). Patients with presenting eGFR as low as 2 – 3 ml/min recovered function.

Conclusion

Timely aggressive therapy to salvage kidney function is crucial. Better predictors of outcome are needed to optimise management in GBM vasculitis.