Characteristics and prognosis of acute renal failure on dialysis in ANCA vasculitis
Renal involvement in ANCA (Anti Neutrophil Cytoplasmic Antigen) vasculitis is common and is associated with increased mortality with a significant risk of progression to end-stage renal disease. The aim of this study is to investigate the epidemiological, clinicopathological, therapeutic and evolutionary characteristics of patients with ANCA vasculitis with acute renal injury, and to evaluate the impact of haemodialysis in the acute phase on mortality and renal recovery. Secondary objectives are to investigate other risk factors that impact on overall and renal survival. 31 patients were included ; the mean follow-up time was 30 months. The mean age was 68.52 years, and the sex ratio 0.72. All patients had acute renal failure, with histology revealing a mixed form in 45% of cases and a sclerotic form in 12.9% of cases. Pulmonary involvement was found in 58% of cases. 71% of patients had ANCA with anti-myeloperoxydase specificity, and 25.8% anti-proteinase 3 specificity. 32.2% of patients required haemodialysis, of which 60% were weaned. As initial treatment, 58.1% of patients received cyclophosphamide and 35.5% rituximab. The relapse rate was 6.5%. Infectious and cardiovascular complications affected more than half of the patients. The mortality rate was 19.35%. Comparing the two groups of patients dialysed in the acute phase and not dialysed, it appears that the overall and renal mortality was comparable. The progression to end-stage renal failure was higher in the dialysis patients. In a multivariate study, the presence of chronic kidney disease in the history and pulmonary involvement were associated with higher mortality.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
|---|---|
| Enthalten in: |
Nephrologie & therapeutique - 20(2024), 1 vom: 28. Feb., Seite 5-16 |
| Sprache: |
Französisch |
|---|
| Weiterer Titel: |
Caractéristiques et pronostic des insuffisances rénales aiguës dialysées au cours des vascularites à ANCA |
|---|
| Beteiligte Personen: |
Siham, Azria [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
ANCA |
|---|
| Anmerkungen: |
Date Completed 29.02.2024 Date Revised 29.02.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1684/ndt.2024.58 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367728486 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367728486 | ||
| 003 | DE-627 | ||
| 005 | 20240229234855.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240129s2024 xx |||||o 00| ||fre c | ||
| 024 | 7 | |a 10.1684/ndt.2024.58 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1311.xml |
| 035 | |a (DE-627)NLM367728486 | ||
| 035 | |a (NLM)38282439 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a fre | ||
| 100 | 1 | |a Siham, Azria |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Characteristics and prognosis of acute renal failure on dialysis in ANCA vasculitis |
| 246 | 3 | 3 | |a Caractéristiques et pronostic des insuffisances rénales aiguës dialysées au cours des vascularites à ANCA |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.02.2024 | ||
| 500 | |a Date Revised 29.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Renal involvement in ANCA (Anti Neutrophil Cytoplasmic Antigen) vasculitis is common and is associated with increased mortality with a significant risk of progression to end-stage renal disease. The aim of this study is to investigate the epidemiological, clinicopathological, therapeutic and evolutionary characteristics of patients with ANCA vasculitis with acute renal injury, and to evaluate the impact of haemodialysis in the acute phase on mortality and renal recovery. Secondary objectives are to investigate other risk factors that impact on overall and renal survival. 31 patients were included ; the mean follow-up time was 30 months. The mean age was 68.52 years, and the sex ratio 0.72. All patients had acute renal failure, with histology revealing a mixed form in 45% of cases and a sclerotic form in 12.9% of cases. Pulmonary involvement was found in 58% of cases. 71% of patients had ANCA with anti-myeloperoxydase specificity, and 25.8% anti-proteinase 3 specificity. 32.2% of patients required haemodialysis, of which 60% were weaned. As initial treatment, 58.1% of patients received cyclophosphamide and 35.5% rituximab. The relapse rate was 6.5%. Infectious and cardiovascular complications affected more than half of the patients. The mortality rate was 19.35%. Comparing the two groups of patients dialysed in the acute phase and not dialysed, it appears that the overall and renal mortality was comparable. The progression to end-stage renal failure was higher in the dialysis patients. In a multivariate study, the presence of chronic kidney disease in the history and pulmonary involvement were associated with higher mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acute kidney injury | |
| 650 | 4 | |a ANCA | |
| 650 | 4 | |a hemodialyse | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a kidney survival | |
| 650 | 4 | |a vascularitis | |
| 650 | 7 | |a Antibodies, Antineutrophil Cytoplasmic |2 NLM | |
| 700 | 1 | |a Hafedh, Fessi |e verfasserin |4 aut | |
| 700 | 1 | |a Jean-Jacques, Boffa |e verfasserin |4 aut | |
| 700 | 1 | |a Pierre-Antoine, Michel |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Nephrologie & therapeutique |d 2005 |g 20(2024), 1 vom: 28. Feb., Seite 5-16 |w (DE-627)NLM164599460 |x 1872-9177 |7 nnns |
| 773 | 1 | 8 | |g volume:20 |g year:2024 |g number:1 |g day:28 |g month:02 |g pages:5-16 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1684/ndt.2024.58 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 20 |j 2024 |e 1 |b 28 |c 02 |h 5-16 | ||