title: End-stage renal disease in ANCA-associated vasculitis.
abstract: The outcomes in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis have improved significantly over the past decades, although a significant proportion of them still reach end-stage renal disease (ESRD). Renal replacement therapy (RRT) is associated with a relatively low risk of relapsing vasculitis as a result of anti-rejection treatment after kidney transplantation or quiescence of the autoimmune process in haemodialysis patients, but a flare of vasculitis in the latter setting presents a challenge because the treatment is poorly tolerated. There are benefits of rituximab in haemodialysed patients, as it is more steroid sparing in the treatment of extrarenal disease. More favourable outcomes of kidney transplantation compared with haemodialysis support its use as a preferable method of RRT in patients with vasculitis remission or low disease activity.
authors.affiliation: Clinic of Nephrology, Internal and Occupational Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
authors.forename: Sergey
authors.initials: S
authors.lastname: Moiseev
authors.affiliation: Clinic of Nephrology, Internal and Occupational Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
authors.forename: Pavel
authors.initials: P
authors.lastname: Novikov
authors.affiliation: Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: David
authors.initials: D
authors.lastname: Jayne
authors.affiliation: Clinic of Nephrology, Internal and Occupational Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
authors.forename: Nikolay
authors.initials: N
authors.lastname: Mukhin
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000628:therapy; D012008:Recurrence
keywords: ANCA-associated vasculitis; end-stage renal disease; haemodialysis; kidney transplantation