Kidney Week

Abstract: SA-PO0796

Process to Diagnosis and Institution of Therapy in Patients with Pauci-Immune Glomerulonephritis

Session Information

• Glomerular Research: Design, Registries, Surveys, and Epidemiology
  November 08, 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, Department of Nephrology Attikon University Hospital, National & Kapodistrian University of Athens, Athens, Greece

Sophia Lionaki, MD, PhD

• Pantzopoulou, Evangelia, Department of Nephrology Attikon University Hospital, National & Kapodistrian University of Athens, Athens, Greece

Evangelia Pantzopoulou, MD

• Pantazopoulou, Yvoni, Department of Nephrology Attikon University Hospital, National & Kapodistrian University of Athens, Athens, Greece

Yvoni Pantazopoulou, MD

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

Maria Koukoulaki, MD, PhD

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

Chrysanthi Skalioti, MD

• Pelagia, Kriki, Department of Nephrology University Hospital of Alexandroupolis, Alexandroupolis, Greece

Kriki Pelagia

• Papasotiriou, Marios, Department of Nephrology University Hospital of Patras, Patras, Greece

Marios Papasotiriou, MD, PhD

• Papachristou, Evangelos, Department of Nephrology University Hospital of Patras, Patras, Greece

Evangelos Papachristou, MD, PhD

• Gkalitsiou, Dimitra, Department of Nephrology Gennimatas General Hospital of Athens, Athens, Greece

Dimitra Gkalitsiou, DrMed

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

Ioannis Petrakis, MD, PhD

• Dounousi, Evangelia, Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece

Evangelia Dounousi, MD, PhD

• Christodoulou, Michalis, Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

Michalis Christodoulou, MD

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

Synodi Zermpala, DrMed

• Tsoumpou, Ioanna, Department of Nephrology Attikon University Hospital, National & Kapodistrian University of Athens, Athens, Greece

Ioanna Tsoumpou

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

Stylianos A. Panagoutsos, MD

• Liakopoulos, Vassilios, Department of Nephrology, Hippokration 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

• Divani, Maria, Department of Nephrology, University of Thessaly, Larissa, Greece

Maria Divani, DrMed, MSc, PhD

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

Maria J. Stangou, MD, PhD

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

Smaragdi Marinaki, PhD

Background

This study evaluated the process following the onset of symptoms associated with PIGN, estimated the time interval and potential delays until diagnosis and institution of appropriate treatment.

Methods

In this retrospective, multicentre study included patients should be older than 16 years, with biopsy-proven PIGN, followed for a minimum of 12 months after diagnosis or end-stage kidney disease or death, and received the standard of care. Demographics, disease characteristics and all the steps from onset of symptoms to the time patients entered the medical system and received the diagnosis were recorded, including the initial symptom, medical visits and specialties, the 1^st management and workup. The dates of 1^st urine analysis and the 1^st ANCA test were recorded.

Results

249 patients with a mean age of 61.97(±13.8) years were included and 132(53.1%) were males. Overall, 231(93.5%) were ANCA positive and 169(73.1%) had MPO P-ANCA. The reason for seeking medical attention was general symptoms in 33.3% of cases. Internists were the most common specialty (55.4%) involved at the 1^st medical assessment, while the 1^st management was non-associated with the disease in 46.6% of cases (“delayed” group), and associated in the rest (“non-delayed” group). The median number of medical visits prior to nephrology referral was 3.1(±2.1) in the “delayed group” vs. 1(±1,5) in the “non-delayed” (p<0.0001) and the time to nephrology referral was 105.5(±141.6) days and 20.1(±48,05) respectively. Urine analysis was performed in 65.4% of patients during the 1^st medical visit in the “delayed” group vs. 87% in the “non-delayed” (p<0.0001), while microscopic hematuria was present in 94.4% in the “delayed” and 98.7% in the “non-delayed” group (p=0.248). Time to 1^st ANCA test was significantly longer in the “delayed” vs. the “non-delayed” group, i.e 115.6 (±76.7) vs. 13.3(±9.5) days from the 1^st assessment.

Conclusion

It seems that urine analysis and ANCA testing performance during the initial phase of evaluation play a critical role for prompt nephrology referral and diagnosis of PIGN.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025gmx2stdm