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Abstract: FR-PO588

Association Between ANCA Kinetic, Renal Survival, and Relapse Risk in ANCA-Glomerulonephritis

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation

Authors

  • Samoreau, Clément, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Piccoli, Giorgina B., Centre Hospitalier du Mans, Le Mans, Pays de la Loire, France
  • Martin, Cecile, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
  • Gatault, Philippe, Centre Hospitalier Regional Universitaire de Tours, Tours, Centre, France
  • Vinatier, Emeline, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Bridoux, Frank, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
  • Riou, Jérémie, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Desouche, Alice, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Jourdain, Pierre, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Wacrenier, Samuel, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Henry, Nicolas, CH de Laval, Laval, France
  • Blanchet, Odile, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Djema, Assia Ilham, CH de Cholet, Cholet, France
  • Pouteau, Lise-Marie, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Copin, Marie-Christine, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Beauvillain, Celine, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Augusto, Jean francois, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
  • Brilland, Benoit, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France
Background

ANCA kinetic in ANCA-associated vasculitis with glomerulonephritis (AAV-GN) has been suggested to be associated with relapse. Few studies focused on its association with renal prognosis. Thus, we aimed to investigate the relationship between i) ANCA specificity and evolutive profile, and ii) renal outcomes.

Methods

This multicentric retrospective study included patients diagnosed with ANCA-GN since 01/01/2000. Patients without ANCA at diagnosis and with fewer than 3 ANCA determinations during follow-up were excluded. We analyzed eGFR variation, renal-free and relapse-free survival according to three ANCA profiles (negative, recurrent, persistent) and to ANCA specificity (MPO or PR3).

Results

Over a median follow-up of 56 months, 19 [13-25] ANCA determinations were performed for the 134 included patients. Patients with a recurrent/persistent ANCA profile had a lower renal- (p = 0.053) and relapse-free (p = 0.019) survival compared to those with negative ANCA profile. Patients with a recurrent/persistent MPO-ANCA profile had the worst renal survival (p = 0.015) and those with recurrent/persistent PR3-ANCA profile had the worst relapse-free survival (p = 0.013) compared to other profiles. In multivariate regression analysis, a negative ANCA profile was an independent predictor of positive 2-year eGFR percent variation (p < 0.001).

Conclusion

ANCA kinetic after ANCA-GN diagnosis is associated with outcomes. MPO-ANCA recurrence/persistence identifies patients with a lower potential of renal recovery and a higher risk of ESKD, while PR3-ANCA recurrence/persistence identifies patients with a greater relapse risk. Thus, ANCA kinetic may help identify patients with a smoldering disease.