Kidney Week

Abstract: FR-PO591

Predicting Death in Anti-Neutrophil Cytoplasmic-Antibody Vasculitis With 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

• Fage, Nicolas, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Nicolas Fage,

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

Jérémie Riou,

• Boud'hors, Charlotte, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France

Charlotte Boud'hors,

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

Alice Desouche,

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

Emeline Vinatier,

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

Clément Samoreau,

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

Samuel Wacrenier,

• Henry, Nicolas, CH Laval, Laval, France

Nicolas Henry,

• Djema, Assia Ilham, Centre Hospitalier de Cholet, Cholet, France

Assia Ilham Djema,

• Pouteau, Lise-Marie, CH Laval, Laval, France

Lise-Marie Pouteau,

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

Marie-Christine Copin,

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

Giorgina B. Piccoli,

• 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

Several scores have been developed to predict death in Anti-Neutrophil Cytoplasmic-Antibody vasculitis (AAV). However, the performance of these scores in AAV with glomerulonephritis (AAV-GN) remains uncertain. We aimed to evaluate their prognostic value and developed our own death prediction risk model in a large cohort of AAV-GN.

Methods

This multicentric retrospective study included patients newly diagnosed with ANCA-GN in 4 French nephrology departments (Maine-Anjou Registry) between 2000 and 2021. Scores (Five Factors Score, FFS; Japanese Vasculitis Activity Score, JVAS; multivariable index for AAV, MVIA; Maldini Score) were assessed at diagnosis before any therapeutic intervention. Clinical, biological and histological characteristics at diagnosis were retrieved. A multivariable cox analysis was performed to determine a death prediction model. Performance (time dependent concordance with C-index and AUC, and prediction accuracy with Brier Score) of these scores and of our model were assessed.

Results

Among the 167 patients included, FFS (HR = 2.78 [2.08-3.73]), JVAS (HR = 1.42 [1.25-1.60]), MVIA (HR = 3.06 [1.66-5.64]) and Maldini [HR = 1.23 (1.10-1.37]) scores were significantly associated with death (with performance decreasing in that order) (Figure 1). In multivariable analysis, age, diabetes, need of early kidney replacement therapy or eGFR, and hemoglobin at diagnosis were associated with death. Two new models including these variables were fit (Table 1) and were found with better performance than the existing scores (Figure 1).

Conclusion

ANCA-GN-specific models perform better in predicting death than existing scores.