Simple, readily available clinical indices predict early and late mortality among patients with ANCA-associated vasculitis

Ágnes Haris, Kálmán Polner, József Arányi, Henrik Braunitzer, Ilona Kaszás, L. Rosivall, Gábor Kökény, I. Mucsi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The early identification of patients with ANCA-associated vasculitis (AAV) who are at increased risk for inferior clinical outcome at the time of diagnosis might help to optimize the immunosuppressive therapy. In this study we wanted to determine the predictive value of simple clinical characteristics, which may be applicable for early risk-stratification of patients with AAV. Methods: We retrospectively analyzed the outcome of 101 consecutive patients with AAV receiving a protocolized immunosuppressive therapy. Baseline Birmingham Vasculitis Activity Score (BVAS) and non-vasculitic comorbidities were computed, then predictors of early (<90 days) and late (>90 days) mortality, infectious death, relapse and end stage kidney disease (ESKD) were evaluated. Results: The baseline comorbidity score independently predicted early mortality (HR 1.622, CI 1.006-2.614), and showed association with infectious mortality (HR 2.056, CI 1.247-3.392). Patients with BVAS at or above median (=21) had worse early mortality in univariable analysis (HR 3.57, CI 1.039-12.243) (p = 0.031), and had more frequent relapses (p = 0.01) compared to patients with BVAS below median. Conclusions: Assessing baseline comorbidities, beside clinical indices characterizing the severity and extension of AAV, might help clinicians in risk-stratification of patients. Future prospective studies are needed to investigate whether therapies based on risk-stratification could improve both short term and long term survival.

Original languageEnglish
Article number76
JournalBMC Nephrology
Volume18
Issue number1
DOIs
Publication statusPublished - Feb 23 2017

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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Mortality
Vasculitis
Comorbidity
Immunosuppressive Agents
Recurrence
Chronic Kidney Failure
Therapeutics
Prospective Studies
Survival

Keywords

  • ANCA
  • BVAS
  • Comorbidity
  • Immunosuppression
  • Outcome
  • Vasculitis

ASJC Scopus subject areas

  • Nephrology

Cite this

Simple, readily available clinical indices predict early and late mortality among patients with ANCA-associated vasculitis. / Haris, Ágnes; Polner, Kálmán; Arányi, József; Braunitzer, Henrik; Kaszás, Ilona; Rosivall, L.; Kökény, Gábor; Mucsi, I.

In: BMC Nephrology, Vol. 18, No. 1, 76, 23.02.2017.

Research output: Contribution to journalArticle

Haris, Ágnes ; Polner, Kálmán ; Arányi, József ; Braunitzer, Henrik ; Kaszás, Ilona ; Rosivall, L. ; Kökény, Gábor ; Mucsi, I. / Simple, readily available clinical indices predict early and late mortality among patients with ANCA-associated vasculitis. In: BMC Nephrology. 2017 ; Vol. 18, No. 1.
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