Abstract: FR-PO0881
Clinical Outcomes and Prognostic Factors in ANCA-Associated Pauci-Immune Crescentic Glomerulonephritis (PICGN): Experience from a Medical Center in Taiwan
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
- Ma, Li-Yi, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
- Tu, Yi-Ran, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
- Chen, Tai-Di, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
- Wu, Tsai-yi, Chang Gung University, Taoyuan, Taoyuan City, Taiwan
- Hsueh, Chih Fang, Chang Gung University, Taoyuan, Taoyuan City, Taiwan
- Ku, Cheng-Lung, Chang Gung University College of Medicine, Taoyuan, Taoyuan City, Taiwan
- Tu, Kun-Hua, Linkou Chang Gung Memorial Hospital, Taoyuan, Taoyuan City, Taiwan
Background
Anti-neutrophil cytoplasmic antibody (ANCA)-associated pauci-immune crescentic glomerulonephritis (PICGN) exhibits with variable renal outcomes. This study aims to assess the clinical characteristics, treatment modalities, and prognostic factors affecting renal survival and dialysis independence in patients treated at Chang Gung Memorial Hospital (CGMH), a tertiary medical center in Taiwan.
Methods
We retrospectively analyzed 65 patients diagnosed with ANCA-associated PICGN, categorized into microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and renal-limited vasculitis (RLV). Clinical parameters, treatment regimens including plasmapheresis, and histopathological classifications were evaluated. Kaplan-Meier survival analysis and log-rank tests were used to assess renal and overall survival, stratified by initial dialysis requirement, creatinine levels, and histological class.
Results
The majority of patients were MPO-ANCA positive (81.5%), with a mean serum creatinine of 7.73 ± 4.16 mg/dL at presentation. Initial dialysis was required in 58.5% of patients, with a significantly lower rate of successful dialysis withdrawal observed in the MPA subgroup (p = 0.011). Plasmapheresis did not significantly improve renal survival in patients with initial creatinine >3.4 mg/dL (p = 0.899) or >5.7 mg/dL (p = 0.965), nor in those requiring dialysis at presentation (p = 0.134). The need for dialysis within the first month was associated with a significantly worse renal outcome (log-rank p < 0.001). Histopathological classification was not a significant predictor of renal survival (log-rank p = 0.168).
Conclusion
In this CGMH cohort, early dialysis requirement within one month was a strong predictor of poor renal prognosis in ANCA-associated PICGN. Plasmapheresis did not confer survival benefits across stratified patient groups. Although histopathological classification was not a significant prognostic factor, its potential value warrants further investigation. These findings underscore the importance of early diagnosis and timely intervention in improving renal outcomes.