Clinical analysis of ANCA-associated renal vasculitis patients with chronic dialysis.
OBJECTIVE
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) constitute a subgroup of life-threatening diseases which affects the kidney in more than half of the patients at diagnosis. Currently, little has been published focusing on AAV patients with dialysis. We analysed AAV patients with chronic dialysis to provide more detailed information.


METHODS
From 1997 to 2011, AAV patients complicated by renal involvement resulting in end-stage renal disease (ESRD) and had undergone haemodialysis (HD) or peritoneal dialysis (PD) for at least 3 months in Shanghai Ruijin hospital were retrospectively analysed in this study. Their data were also compared to those without dialysis at the same time.


RESULTS
We enrolled 49 AAV patients with chronic dialysis. 41 required dialysis at initial presentation and rest 8 progressed to ESRD during follow-up. 19 HD patients died and 6 PD patients died during follow-up, and infection was the most common cause among the patients. There was no significant difference regarding survival between HD patients and PD patients (p>0.05). However anaemia and level of triglyceride was more significantly improved in HD patients at the end of observation (p<0.05, p<0.05 respectively). Compared with patients without dialysis dependency, dialysis patients presented higher percentage of hypertension (p<0.01), more severe renal involvement and higher BVAS (p<0.01). For the outcome, survival was significantly higher in non-dialysis patients (p<0.05).


CONCLUSIONS
Patients with AAV experienced a high rate of renal failure and dialysis dependence. Our study suggests that haemodialysis and peritoneal dialysis are two comparable dialysis modalities for AAV patients with ESRD. However, AAV patients with dialysis dependency had worse outcome in comparison with those without dialysis.
Department of Nephrology, Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025, PR China. rickychen@live.com.
Yong-Xi
YX
Chen
Wen
W
Zhang
Xiao-Nong
XN
Chen
Li-Yan
LY
Ni
Ping-Yan
PY
Shen
Wei-Ming
WM
Wang
Nan
N
Chen
D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000276:immunology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
D019268:Antibodies, Antineutrophil Cytoplasmic; D006454:Hemoglobins; D003404:Creatinine