Table 3.
Clinical characteristics and outcomes of patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) with glomerulonephritis (AAV-GN) and eGFR <15 ml/min per 1.73 m2 at diagnosis who started dialysis in the first 4 weeks of AAV-GN diagnosis according to dialysis status (n = 71)
| Clinical characteristics and outcomes | Permanent n = 44 (62.0%) | Transient n = 27 (38.0%) | P-value |
|---|---|---|---|
| Age at diagnosis, median (IQR), yr | 65 (55.3–73.2) | 66 (60.0–72.0) | 0.967 |
| Male, n (%) | 29 (65.9) | 18 (66.7) | 0.781 |
| AAV, n (%) | 0.046a | ||
| MPA | 27 (61.4) | 10 (37.0) | |
| GPA | 17 (38.6) | 17 (63.0) | |
| ANCA specificity (ELISA), n (%) | 0.071 | ||
| MPO | 26 (59.1) | 10 (37.0) | |
| PR3 | 18 (40.9) | 17 (63.0) | |
| BVAS/WG at diagnosis, median (IQR) | 8 (7–13) | 8 (7–9) | 0.201 |
| Alveolar hemorrhage BVAS/WG at diagnosis, n (%) | 13 (29.5) | 8 (29.6) | 0.994 |
| Cardiovascular risk factors, n (%) | |||
| Arterial hypertension | 36 (81.8) | 18 (66.7) | 0.146 |
| Diabetes mellitus | 16 (36.4) | 6 (22.2) | 0.211 |
| Dyslipidemia | 19 (43.2) | 15 (55.6) | 0.311 |
| BMI > 30 kg/m2 | 15 (34.1) | 8 (29.6) | 0.876 |
| Laboratory findings | |||
| Hemoglobin, mean (SD), g/dl | 8.6 (1.64) | 9.4 (1.58) | 0.035a |
| ESR, median (IQR) mm/1sth | 61 (41.5–93.0) | 94 (50.8–98.8) | 0.122 |
| SCr at diagnosis, median (IQR), mg/dl | 6.9 (4.8–9.3) | 5.0 (2.7–7.0) | 0.011a |
| eGFR at diagnosis, median (IQR), ml/min per 1.73 m2 | 7.6 (4.93–10.76) | 10.3 (6.59–17.97) | 0.033a |
| eGFR at 6 months, median (IQR), ml/min per 1.73 m2 | 12.1 (9.34–16.54) | 32.8 (25.05–40.14) | <0.0001a |
| eGFR at 12 months, median (IQR), ml/min per 1.73 m2 | 9.1 (5.05–32.39) | 30.3 (22.89–44.80) | 0.021a |
| MCCS, n (%) | 0.007a | ||
| Minimal | 3 (6.8) | 10 (37.0) | 0.002a |
| Mild | 15 (34.1) | 10 (37.0) | 0.805 |
| Moderate | 16 (36.4) | 6 (22.2) | 0.212 |
| Severe | 10 (22.7) | 1 (3.7) | 0.033a |
| MCCS, median (IQR), points | 5 (3.0–7.0) | 3 (1.0–5.0) | 0.001a |
| Intervention | |||
| Remission-induction treatment, n (%) | 0.303 | ||
| Cyclophosphamide | 23 (52.3) | 14 (51.9) | 0.974 |
| Rituximab | 16 (36.4) | 13 (48.1) | 0.334 |
| Remission-induction adjuvant therapies, n (%) | |||
| Plasma exchange therapy | 20 (45.5) | 16 (59.3) | 0.259 |
| i.v. methylprednisolone at induction remission | 39 (88.6) | 25 (92.6) | 0.587 |
| Outcomes, n (%) | |||
| Relapse | 8 (18.2%) | 11 (40.7) | 0.037a |
| ESKD 12 mo | 44 (100.0) | 0 (0.0) | <0.0001a |
| Death | 23 (52.3) | 5 (18.5) | 0.005a |
| Infection | 21 (47.7) | 14 (51.9) | 0.567 |
| Time of FU after renal involvement, median (IQR), mo | 35 (4.0–85.5) | 57 (24.0–82.0) | 0.103 |
AAV, ANCA-associated vasculitis; ANCA, antineutrophil cytoplasmic antibodies; BMI, body mass index; BVAS/WG, Birmingham Vasculitis Activity Score for Wegener's Granulomatosis; eGFR, estimated glomerular filtration rate; ELISA, enzyme-linked immunosorbent assay; ESKD, end-stage kidney disease; ESR, erythrocyte sedimentation rate; FU, follow-up; GPA, granulomatosis with polyangiitis; IQR, interquartile range; MCCS, Mayo Clinic Chronicity score; MPA, microscopic polyangiitis; MPO, myeloperoxidase; PLEX, plasma exchange; PR3, proteinase 3; SCr, serum creatinine.
P ≤ 0.05, indicate statistical significance.