Abstract: FR-PO0670
Severe Kidney Involvement and Therapeutic Gaps in Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Mexican Tertiary-Center Cohort
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
- Rodriguez Alvarez, Karen Guadalupe, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, Mexico
- Galindo, Pablo E., Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, Mexico
- De La Paz, Sofía Velázquez, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, Mexico
- Perez-Navarro, L. Monserrat, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, Mexico
- Prestegui, David E., Hospital Regional ISSSTE "Lic. Adolfo Lopez Mateos", Mexico City, Mexico
- Cordoba Hurtado, Angela Maria, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, Mexico
Background
ANCA-associated vasculitis (AAV) is a rare multisystem disease with high renal morbidity. Latin American real-world data remain limited. Characterizing tertiary-care cohorts may identify disease burden and barriers to specialized treatment.
Methods
We performed a retrospective descriptive study of AAV patients from a Mexican tertiary-care referral center. Demographic data, ANCA serotype, renal function, histopathology, treatment exposure, complications, and outcomes were evaluated. Continuous variables are presented as median [IQR] and categorical variables as n/N (%).
Results
Fifty patients were included. Median age was 45.0 years (34.0–58.0), and 27/49 (55.1%) were female. Hypertension was present in 21/48 (43.8%) and type 2 diabetes in 9/48 (18.8%). MPO-ANCA was predominant in 31/49 (63.3%), followed by PR3-ANCA in 11/49 (22.4%). Median BVAS at diagnosis was 21.0 [18.0–25.0], reflecting high disease activity. Renal involvement was severe, with serum creatinine of 7.8 mg/dL
[4.9–11.0] and eGFR of 5.0 mL/min [3.0–9.0]. Renal replacement therapy was required in 23/34 (67.6%). Kidney biopsy was performed in 41/49 (83.7%); sclerotic class was the most frequent pattern, 16/39 (41.0%), suggesting advanced chronic renal injury.
Therapeutic plasma exchange was indicated in 47/49 (95.9%), although only 10/48 (20.8%) received it, demonstrating a marked therapeutic gap. Methylprednisolone pulses were administered in 34/38 (89.5%), cyclophosphamide in 31/40 (77.5%), and rituximab in 2/36 (5.6%). Severe infections occurred in 7/28 (25.0%), while mortality was observed in 5/47 (10.6%).
Conclusion
This Mexican tertiary-center cohort showed severe renal disease at diagnosis, MPO-ANCA predominance, frequent dialysis requirement, and chronic histopathologic damage. Despite broad indication for plasma exchange, access was limited, suggesting delayed referral and need for earlier diagnosis.
Acknowledgment
No external funding was received for this study.