Abstract: FR-PO0647
Cardiovascular Risk Profiling and Protection in ANCA-Associated Glomerulonephritis: Analyses of Risk Factors and Benefit of SGLT2 Inhibition in Real-World Data Sets
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
- Tangwanchai, Taksaporn, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Hartemink, John William, Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
- Brix, Silke R., The University of Manchester, Manchester, England, United Kingdom
Background
Cardiovascular mortality is significantly higher in ANCA associated vasculitis (AAV). SGLT2i improve renal and cardiovascular outcomes in chronic kidney disease but is perhaps less frequently used in patients with ANCA GN due to rapid loss of function within a few weeks. We investigated CVD burden and evaluated the association of SGLT2i use with renal outcomes in AAV and ANCA GN.
Methods
A retrospective single-centre ANCA GN cohort (2006-2025) was reviewed to investigate prevalence and vasculitis related risk parameters. In parallel, the TriNetX global federated health research network was used to identify patients with a new diagnosis of AAV receiving SGLT2i with the primary endpoint ESKD.
Results
A total of 288 patients were reviewed. 34.03% suffered CVD events with 16.32% before and 17.71% following the diagnosis of ANCA GN, significantly higher than the current estimate in the general population. Patients were fewer never smokers (52.31%) compared to the general population; 41.28% recorded as ex-smokers and a remaining 6.41% as active smokers.
Active and ex-smokers demonstrated higher numbers of CVD prior to the onset of ANCA GN compared to never smokers (27.78%, 18.10% vs 13.61%). Following the vasculitis diagnosis, CVD events did rise in never smokers (19.05%).
In TriNetX, an initial analysis revealed a significant benefit between the two groups (SGLT2i vs control, p<0.001). We then propensity matched patients for age, gender, ethnicity, kidney function and background diagnoses. After removing patients suffering from kidney failure within 3 months of diagnosis, we added additional propensity matching for treatments and stroke, and 728 patients were included in each arm. Comparing treatment effects, SGLT2i use was still associated with a reduced rate of ESKD (HR 0.566, 95% CI 0.324–0.989). A composite outcome of ESKD and death showed an absolute risk reduction of 4.5% over five years, corresponding to a number needed to treat (NNT) of 22. Confidence intervals remained wide due to the relatively low number of events.
Conclusion
Smoking seems to worsen CVD related outcomes as previously suggested.
SGLT2i use associated with a reduction in ESKD and death in AAV, with an NNT of 22 over five years. These findings suggest renal-protective effects of SGLT2i in systemic vasculitis transferrable from other kidney conditions.
Funding
- Government Support – Non-U.S.