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Abstract: PO1608

Clinical Characteristics and Outcomes of Severe ANCA-Associated Renal Disease in a Multiethnic Urban Population

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Leonard, Allison Jean, John H Stroger Hospital of Cook County, Chicago, Illinois, United States
  • Arora, Shilpa, Rush University Medical Center, Chicago, Illinois, United States
  • Athavale, Ambarish, John H Stroger Hospital of Cook County, Chicago, Illinois, United States
Background

To study the clinical characteristics, treatment and outcomes of ANCA vasculitides patients in an inner-city county hospital.

Methods

Retrospective study of 60 patients with biopsy-proven ANCA glomerulonephritis and a minimum follow-up of 6 months (median, IQR 23, 29 months) were included. Demographic and clinical information including pathology data, treatment and outcomes were collected. Multivariate regression analyses were done to study predictors of outcomes of estimated Glomerular Filtration Rate (eGFR) at 6 months and End Stage kidney Disease (ESKD).

Results

Patients represented an ethnically diverse population (Figure 1) with baseline characteristics as shown in Table 1. Mean age (SD) at diagnosis was 57.4 (13.7). Almost all patients (59/60, 98.3%) presented with hematuria and 17/60 (28.3%) had nephrotic-range proteinuria. Extra renal involvement most commonly pulmonary was seen in 35/60 (58.3%) patients. 44/60 (73.0%) had crescents and nearly all had interstitial fibrosis and tubular atrophy (IFTA) (median, IQR 30%, 56%). Most patients were induced with cyclophosphamide (49/60, 81.7%) and 16/60 (26.7%) received plasma exchange. eGFR (mean±SD) at baseline and 6 months follow up were 20.8±19.4 and 43.5±23.0 respectively. 15/60 (25%) patients progressed to ESKD. On multivariate linear regression analysis, age (B -0.5), IFTA (B -27.7) and baseline eGFR (B 0.3) predicted eGFR at 6 months and IFTA (OR, 95% CI, 111.5, 1.1-11907.7) and eGFR at 6 months (OR 0.9, 95% CI 0.8-1.0) were associated with ESKD (P <0.05) on multivariate logistic regression analysis. Ethnicity, ANCA type or titer, crescents on biopsy and treatment received did not predict eGFR at 6 months or ESKD.

Conclusion

In this cohort of patients with severe ANCA glomerulonephritis IFTA and baseline eGFR were the most significant predictors of eGFR at 6 months follow up which in turn was associated with progression to ESKD.

Patient Demographics