Kidney Week

Abstract: FR-PO588

Association Between ANCA Kinetic, Renal Survival, and Relapse Risk in ANCA-Glomerulonephritis

Session Information

• Glomerular Diseases: Lupus and Vasculitis
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1302 Glomerular Diseases: Immunology and Inflammation

Authors

• Samoreau, Clément, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Clément Samoreau,

• Piccoli, Giorgina B., Centre Hospitalier du Mans, Le Mans, Pays de la Loire, France

Giorgina B. Piccoli,

• Martin, Cecile, Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Cecile Martin,

• Gatault, Philippe, Centre Hospitalier Regional Universitaire de Tours, Tours, Centre, France

Philippe Gatault,

• Vinatier, Emeline, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Emeline Vinatier,

• Bridoux, Frank, Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Frank Bridoux,

• Riou, Jérémie, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Jérémie Riou,

• Desouche, Alice, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Alice Desouche,

• Jourdain, Pierre, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Pierre Jourdain,

• Wacrenier, Samuel, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Samuel Wacrenier,

• Henry, Nicolas, CH de Laval, Laval, France

Nicolas Henry,

• Blanchet, Odile, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Odile Blanchet,

• Djema, Assia Ilham, CH de Cholet, Cholet, France

Assia Ilham Djema,

• Pouteau, Lise-Marie, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Lise-Marie Pouteau,

• Copin, Marie-Christine, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Marie-Christine Copin,

• Beauvillain, Celine, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Celine Beauvillain,

• Augusto, Jean francois, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Jean francois Augusto,

• Brilland, Benoit, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Benoit Brilland,

Background

ANCA kinetic in ANCA-associated vasculitis with glomerulonephritis (AAV-GN) has been suggested to be associated with relapse. Few studies focused on its association with renal prognosis. Thus, we aimed to investigate the relationship between i) ANCA specificity and evolutive profile, and ii) renal outcomes.

Methods

This multicentric retrospective study included patients diagnosed with ANCA-GN since 01/01/2000. Patients without ANCA at diagnosis and with fewer than 3 ANCA determinations during follow-up were excluded. We analyzed eGFR variation, renal-free and relapse-free survival according to three ANCA profiles (negative, recurrent, persistent) and to ANCA specificity (MPO or PR3).

Results

Over a median follow-up of 56 months, 19 [13-25] ANCA determinations were performed for the 134 included patients. Patients with a recurrent/persistent ANCA profile had a lower renal- (p = 0.053) and relapse-free (p = 0.019) survival compared to those with negative ANCA profile. Patients with a recurrent/persistent MPO-ANCA profile had the worst renal survival (p = 0.015) and those with recurrent/persistent PR3-ANCA profile had the worst relapse-free survival (p = 0.013) compared to other profiles. In multivariate regression analysis, a negative ANCA profile was an independent predictor of positive 2-year eGFR percent variation (p < 0.001).

Conclusion

ANCA kinetic after ANCA-GN diagnosis is associated with outcomes. MPO-ANCA recurrence/persistence identifies patients with a lower potential of renal recovery and a higher risk of ESKD, while PR3-ANCA recurrence/persistence identifies patients with a greater relapse risk. Thus, ANCA kinetic may help identify patients with a smoldering disease.