Kidney Week

Abstract: FR-PO0845

Kidney Outcomes in Skin-Limited vs. Systemic Vasculitis: Real-World Comparative Analysis Using the TriNetX Global Network

Session Information

• Glomerular Outcomes: From Proteinuria to Prognosis
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Matarneh, Ahmad, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Ahmad Matarneh, MD

• Matarneh, Bayan, Detroit Medical Center, Detroit, Michigan, United States

Bayan Matarneh, MD

• Sardar, Sundus, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Sundus Sardar, MD

• Akkari, Abdel-Rauof M., Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Abdel-Rauof M. Akkari, MD

• Salameh, Omar Khaleel Mohammad, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Omar Khaleel Mohammad Salameh, MBBS

• Verma, Navin, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Navin Verma, MD

• Ghahramani, Nasrollah, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States

Nasrollah Ghahramani, MD, FASN

Background

Cutaneous leukocytoclastic vasculitis (LCV) is often regarded as a skin-limited condition, yet may represent an early or indolent form of systemic vasculitis with potential for renal involvement. We sought to compare kidney-related outcomes in patients with isolated skin-limited vasculitis versus those with systemic vasculitis, using a large real-world data network.

Methods

We used the TriNetX Global Collaborative Network (148 healthcare organizations) to identify adults (≥18 years) with either:
(A) Skin-limited vasculitis – defined by ICD-10 codes for cutaneous vasculitis without prior systemic involvement; or
(B) Systemic vasculitis – defined by ICD-10 codes for systemic vasculitides without concurrent cutaneous diagnosis.
Patients with pre-existing chronic kidney disease (CKD) or prior glomerulonephritis were excluded. The index date was the first recorded vasculitis diagnosis. All patients were followed for 12 months to assess the incidence of:
Acute kidney injury (AKI), Glomerulonephritis (GN), Proteinuria, CKD (any stage), Dialysis dependence or end-stage renal disease (ESRD)
Risk ratios (RRs) were calculated, and Kaplan-Meier analyses were performed for renal event–free survival.

Results

A total of 27,580 patients with skin-limited vasculitis and 18,892 with systemic vasculitis were analyzed. At 1 year, the incidence of renal outcomes was significantly higher in the systemic vasculitis group:
AKI: 1.9% (skin-limited) vs. 6.7% (systemic); RR 3.58
GN: 0.8% vs. 3.4%; RR 4.25
CKD: 3.5% vs. 9.1%; RR 2.60
Proteinuria: 1.2% vs. 3.9%; RR 3.25
Dialysis/ESRD: 0.2% vs. 1.1%; RR 5.50

Kaplan-Meier curves showed significantly lower renal event–free survival in systemic vasculitis (p<0.001).

Conclusion

Systemic vasculitis is associated with a markedly increased risk of renal complications compared to skin-limited disease. However, even patients with cutaneous vasculitis alone are at risk for kidney involvement. These findings underscore the need for renal surveillance in all vasculitis patients and raise awareness that skin-limited presentations may not remain confined to the dermis.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025y7fenjcx