Abstract: FR-PO0664
Effect of Dialysis on In-Hospital Outcomes in ANCA-Associated Vasculitis
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Zafar, Muhammad Usman, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
- Zaidi, Syed Haris Mustafa, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
- Aziz, Ansar, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
- Aown, Syed, St Luke's University Health Network, Bethlehem, Pennsylvania, United States
Background
ANCA-associated vasculitis (AAV) is a systemic small-vessel vasculitis frequently involving the kidneys and can lead to severe renal failure requiring dialysis. National data describing outcomes in this population remains limited. Here we use National Inpatient Sample (NIS) to understand hospital outcomes in this group.
Methods
We performed a retrospective analysis of the 2018 NIS database. Adult hospitalizations with AAV were identified using ICD-10 codes for granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. Dialysis during hospitalization was identified using ICD-10 procedure codes for renal replacement therapy excluding patients that were already on dialysis. Multivariate logistic and linear regression analysis models in STATA MP 19 evaluated associations between dialysis requirement and inpatient mortality, length of stay (LOS) and hospitalization costs while adjusting for various comorbidities including acute kidney injury (AKI), chronic kidney disease (CKD), heart failure, diabetes and chronic liver disease.
Results
An total of 2,374 hospitalizations (adults >18 years) were were identified, representing an estimated 11,870 hospitalizations nationally. Mean age was 63 years and 57% were females. Dialysis was required in 4% of hospitalizations. Dialysis requirement was associated with higher inpatient mortality (OR 2.55, 95% CI 1.32 – 4.96, p = 0.006) with mortality rates of 16.7% compared with 2.63% in those not requiring dialysis. Additional predictors of mortality included AKI (OR 3.23, 95% CI 1.70 - 6.16), sepsis (OR 4.34, 95% CI 2.00 - 9.43), chronic liver disease (OR 7.27, 95%CI 3.51 - 15.10) and increasing age (OR1.03 per year).
Mean LOS was 7.09 days (95% CI 6.77 - 7.42). Dialysis was associated with a longer LOS by ~6.5 days (Coef. 6.50, 95% CI 4.24 – 8.76). LOS was higher in patients with AKI(Coef. 3.18, 95% CI 2.44 - 3.94). Dialysis requirement increased hospitalization cost by $138500 (95% CI 94396.84 – 182604.5). Additional cost drivers included AKI, sepsis and heart failure.
Conclusion
Although dialysis was required by a minority of hospitalizations with AAV, it was associated with substantially worse outcomes, including higher mortality, greater LOS and healthcare costs. These findings highlight the significant burden of severe renal involvement in AAV and emphasize the importance of early recognition and aggressive management.