July 23, 2024

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Alarming Prevalence of Advanced Kidney Disease at Diagnosis of ANCA-Associated Vasculitis: A Call for Early Action

2 min read
Advanced kidney disease is a common and serious complication of ANCA-associated vasculitis (AAV). Early diagnosis and treatment are essential for improving long-term outcomes in patients with this condition. This article discusses the prevalence of advanced kidney disease at presentation with AAV, the risks of relapse and progression to renal replacement therapy, and the importance of early intervention with aggressive immunosuppressive therapy.
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ANCA-associated vasculitis (AAV) is a group of rare autoimmune diseases that cause inflammation and damage to blood vessels. The kidneys are a common target of AAV, and advanced kidney disease is a frequent complication. A recent study presented at the American Society of Nephrology’s Kidney Week 2023 conference found that advanced kidney disease is common at presentation with AAV, with differences between the two major histologic subtypes of the condition.

Key Findings

  • The study included 278 patients with AAV, of which 49.3% had granulomatosis with polyangiitis (GPA) and 42.1% had microscopic polyangiitis (MPA).
  • At presentation, the median estimated glomerular filtration rate (eGFR) for the group was 18 mL/min/1.73 m2, and 19.4% were receiving renal replacement therapy.
  • Relapse occurred in 23% of patients, and 26.6% progressed to renal replacement therapy.
  • The 1-year mortality rate was 3.2%.

Implications

The findings of this study underscore the importance of early diagnosis and treatment of AAV. Patients with AAV who present with advanced kidney disease are at increased risk of relapse and progression to renal replacement therapy. Early intervention with aggressive immunosuppressive therapy can help to preserve kidney function and improve long-term outcomes.

Recommendations

  • Patients with symptoms of AAV, such as fatigue, bloody urine, and shortness of breath, should be promptly evaluated by a nephrologist.
  • Early diagnosis of AAV can be achieved through blood tests and kidney biopsy.
  • Aggressive immunosuppressive therapy is the mainstay of treatment for AAV.
  • Regular monitoring of kidney function is essential for patients with AAV.

Advanced kidney disease is a common complication of AAV. Early diagnosis and treatment are crucial for improving long-term outcomes in patients with this condition.

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