Abstract: FR-PO0421
Prognostic Value of ANCA Kidney Risk Score for Kidney Outcomes in ANCA-Associated Vasculitis: A Retrospective Study
Session Information
- AKI: Biomarkers, Diagnostics, and Risk Prediction
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Donoso-Naranjo, Paola G., Hospital Universitario Virgen del Rocio, Seville, AL, Spain
- Alarcon, Carmen Ca, Hospital Universitario Virgen del Rocio, Seville, AL, Spain
- Batalha-Caetano, Paula, Hospital Universitario Virgen del Rocio, Seville, AL, Spain
- Pérez Valdivia, Miguel Angel, Hospital Universitario Virgen del Rocio, Seville, AL, Spain
- Arellano, Macarena Naranjo, Hospital Universitario Virgen del Rocio, Seville, AL, Spain
Background
ANCA-associated vasculitis (AAV) with renal involvement has variable prognosis, making precise risk stratification essential. We evaluated the prognostic value of the ANCA Kidney Risk Score (AKRiS) and Berden’s histological classification, analyzing clinical and pathological factors associated with renal outcomes.
Methods
We retrospectively analyzed 46 adults with biopsy-proven AAV and renal involvement from a single center (2022–2025). Data included clinical, laboratory, and histological variables. Patients were classified by AKRiS and Berden. The primary outcome was hemodialysis at 6 months; secondary outcomes were eGFR change and renal recovery.
Results
Median age was 66.5 years; 52.2% were women. Hypertension (47.8%) and prior CKD (32.6%) were common. Pulmonary, ENT, and neurologic involvement occurred in 13–15% of patients. At diagnosis, median eGFR was 15.7 mL/min/1.73m2, proteinuria 976.5 mg/g, and MPO-ANCA positive in 76.1%. By AKRiS: 4.3% low, 47.8% moderate, 19.6% high, 28.3% very high risk. By Berden: focal 21.7%, crescentic 32.6%, mixed 26.1%, sclerotic 19.6%.
Renal function declined at diagnosis and partially recovered at 6 months (eGFR: baseline 47.0, diagnosis 16.0, 6 months 28.0 mL/min/1.73m2; p<0.001). No low/moderate AKRiS patient required hemodialysis at 6 months, versus 30% of high/very high-risk (p=0.006). Dialysis risk increased with AKRiS score. Berden classification did not predict dialysis need. Of 9 patients on dialysis at diagnosis, 6 discontinued by 6 months; none in G5 at 6 months recovered. KDIGO stage at 6 months predicted outcome (p<0.001)
Conclusion
AKRiS was a strong predictor of renal outcome and dialysis need in AAV, outperforming histological classification. Most recovery occurred within 6 months, underscoring the need for early risk identification and intervention.