Kidney Week

Abstract: FR-PO0863

Delayed Diagnosis of Pauci-Immune Glomerulonephritis Is Associated with Increased Severity of Disease Presentation and Higher Probability of Death

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

• Lionaki, Sophia, Attikon University Hopsital, National & Kapodistrian University of Athens, Athens, Greece

Sophia Lionaki, MD, PhD

• Skalioti, Chrysanthi, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece

Chrysanthi Skalioti, MD

• Pantzopoulou, Evangelia, Attikon University Hopsital, National & Kapodistrian University of Athens, Athens, Greece

Evangelia Pantzopoulou, MD

• Pantazopoulou, Yvoni, Attikon University Hopsital, National & Kapodistrian University of Athens, Athens, Greece

Yvoni Pantazopoulou, MD

• Kourtidou, Christodoula, Department of Nephrology, Ahepa Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Christodoula Kourtidou, MD

• Gkika, Louiza, University Hospital of Ioannina, Ioannina, Greece

Louiza Gkika, MD

• Koukoulaki, Maria, General Hospital of Nikaia, Athens, Greece

Maria Koukoulaki, MD, PhD

• Zermpala, Synodi, General Hospital of Nikaia, Athens, Greece

Synodi Zermpala, DrMed

• Papachristou, Evangelos, University Hospital of Patras, Patras, Achaia, Greece

Evangelos Papachristou, MD, PhD

• Moustakas, Georgios, Gennimatas General Hospital of Athens, Athens, Greece

Georgios Moustakas, MD, PhD

• Petrakis, Ioannis, University Hospital of Heraklion, Heraklion, Greece

Ioannis Petrakis, MD, PhD

• Stylianou, Konstantinos, Department of Nephrology, University of Thessaly, Larissa, Greece

Konstantinos Stylianou, MD, PhD

• Papasotiriou, Marios, University Hospital of Patras, Patras, Achaia, Greece

Marios Papasotiriou, MD, PhD

• Liakopoulos, Vassilios, Department of Nephrology, Ahepa Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Vassilios Liakopoulos, MD, PhD

• Stefanidis, Ioannis, Department of Nephrology, University of Thessaly, Larissa, Greece

Ioannis Stefanidis, MD, PhD

• Panagoutsos, Stylianos A., University Hospital of Alexandroupolis, Alexandroupolis, Greece

Stylianos A. Panagoutsos, MD

• Stangou, Maria J., Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Maria J. Stangou, MD, PhD

• Marinaki, Smaragdi, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece

Smaragdi Marinaki, PhD

Background

Delays in diagnosing pauci-immune glomerulonephritis (PIGN) may play a critical role in the prognosis of these patients. This study investigated the impact of delays in diagnosing PIGN in disease presentation and outcome.

Methods

A retrospective, multicenter study with patients older than 16 years, with biopsy-proven PIGN, who were followed for a minimum of 12 months or until ESKD or death. We recorded demographics, disease-related characteristics and outcomes including treatment resistance, remission, ESKD, and death. The observation period started when the patients entered the medical system until ESKD, or death or the last visit to the clinic. Patients were categorized with respect to the management at 1^st medical visit as “delayed” (non-associated with the disease management) and “non-delayed” (workup led to diagnosis or direct nephrology referral).

Results

249 patients with a mean age of 61.97(±13.8) years were included, of whom 132 (53.1%) were males. Overall, 93,5% were ANCA positive and 169 (73,1%) had P/MPO-ANCA. 116 patients were categorized as “delayed” and 133 as “non-delayed” diagnosis. Time to diagnostic biopsy from the 1^st medical visit was 104,3 (±87,1) days and 15,6(±7,5) days (p<0.0001) respectively, while renal limited vasculitis accounted for 24% in both groups. Serum creatinine at diagnosis revealed a significant increase for those with “delayed” diagnosis when compared with their value at 1^st assessment, while this was not observed for the non-delayed group. BVAS at diagnosis was increased in the “delayed” group, compared with their estimate at 1^st assessment, [13,9(±6,6) vs. 17,7(±5,9), p=0,0001]. The probability of ESKD and death within the 1^st year was higher in the “delayed” group (15,9% vs. 6,95%, p=0,0425) and (10,2% vs. 1.7%, p=0,008).

Conclusion

Patients with PIGN, who experience diagnostic delays are more likely to start treatment with advanced disease severity, end more frequently in ESKD and have higher probability of death during the 1^st year after diagnosis.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20251he843jb