Abstract: FR-PO0644
Clinicopathologic Characteristics and Short-Term Outcomes of Medium-Vessel Involvement in ANCA-Associated Vasculitis: A Chinese Cohort Study
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
- Hua, Dujuan, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
- Pan, Xiaoxia, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
- Xie, Jingyuan, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
- Xu, Jing, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
Background
ANCA-associated vasculitis (AAV) is an autoimmune disease affecting small vessels, commonly causing necrotizing and crescentic glomerulonephritis. There is limited research on kidney pathology and short-term outcomes in AAV patients with arteritis.
Methods
A retrospective study examined AAV patients with native renal biopsies from 2012-2025, excluding cases with relapsed/secondary AAV/other pathologies. Patients were divided into medium-vessel vasculitis (MVV) and non-MVV groups to compare baseline characteristics, pathology, lab results, and short-term prognosis.
Results
Of 272 patients (mean age 60.9±11.9 years; M/F=0.8), 21 (7.7%) had MVV and 251 (92.3%) did not. MVV patients had lower systolic BP (123.9±13.2 vs 140.6±20.5 mmHg), proteinuria (1.1±0.6 vs 2.1±1.6 g/d), albumin (24.5±3.6 vs 30.4±5.2 g/L), hemoglobin (82.6±12.7 vs 92.0±20.5 g/L), and higher BAVS (23.4±9.3 vs 18.4±4.3) and hs-CRP (98.5±95.4 vs 19.3±32.6); age, sex, DBP, eGFR, hematuria, glomeruli count, and total/cellular/fibrocellular crescents did not differ. Less chronic damage (fewer global glomerulosclerosis 9.5% vs 43.0%; lower circumferential/large crescents 0[0-8.3] vs 10.3[0-23.5]) yet more active injury (higher necrotic glomeruli 24.5±24.7% vs 11.9±13.1%; more Bowman’s capsule rupture 0.9±0.8 vs 0.3±0.6) (Figure 1). ESRD did not differ, but mortality was higher in MVV (42.9% vs 3.2%) (Table 1). All significant comparisons P<0.05.
Conclusion
MVV in AAV combines active necrotizing injury and Bowman’s capsule rupture with less chronic damage and a paradoxical clinical picture — marked systemic inflammation despite lower blood pressure, proteinuria, and albumin. MVV carries markedly higher short-term mortality without increased ESRD, identifying a high-risk phenotype requiring intensified surveillance and aggressive treatment.
Acknowledgment
We are grateful to Professor Anthony Chang from University of Chicago for his valuable insights and constructive suggestions that improved this work. We gratefully acknowledge Dr. Pingyan Shen from the Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, for her support.
Funding
- Government Support – Non-U.S.