Kidney Week

Abstract: SA-PO762

Clinical Frailty as a Proxy Measure for Infection Risk in ANCA-Associated Glomerulonephritis

Session Information

• ANCA-Associated Vasculitis, Anti-GBM Disease, and Other RPGN
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Durailingam, Joshendra, The University of Manchester, Manchester, United Kingdom

Joshendra Durailingam, MBChB

• Gulati, Kavita, Imperial College London, London, United Kingdom

Kavita Gulati, MBChB

• Chapman, Gavin, University of Edinburgh, Edinburgh, United Kingdom

Gavin Chapman, MBChB

• Dhaun, Neeraj, University of Edinburgh, Edinburgh, United Kingdom

Neeraj Dhaun, MD, PhD, FASN

• McAdoo, Stephen Paul, Imperial College London, London, United Kingdom

Stephen Paul McAdoo, MA, MBBS, PhD

• Brix, Silke R., The University of Manchester, Manchester, United Kingdom

Silke R. Brix, MD

Background

Frailty is a functional term referring to a decline in physiological function that leads to dependency, vulnerability and a high risk for poor health-related outcomes. Anti-neutrophil cytoplasmic antibody (ANCA) vasculitis affects the elderly and often results in a rapid decline in the general health. We aim to better understand the interaction between the rapid evolving ANCA associated inflammation and the impression of frailty to improve prediction modelling for adverse outcomes. Here, we investigated clinical frailty scale (CFS) at time of diagnosis for its association with clinical outcomes.

Methods

We performed a three-centre, retrospective analysis of newly diagnosed ANCA glomerulonephritis (GN) patients in the UK. Wilcoxon-Rank-Sum, Kruskal-Wallis and Fisher-Exact testing were used to analyse the relationships of age, CFS and infections, end stage kidney disease (ESKD) and death.

Results

A total of 275 patients were included, median follow-up 3.8 years (interquartile range, IQR, 2.1 – 5.3 years). The median age at presentation was 66.3 years (IQR, 54.7 – 74.5 years) and 145 were of male gender (52.3%). A total of 86 patients developed ESKD (31.3%), and 77 patients died (28%) during follow-up. Data on infection during the first year was available on 158 patients.
Age and CFS did not influence the development of ESKD (p=0.4 and p=0.21). Higher age and CFS were both associated with deaths during follow up (p=0.004 and p=0.002). The frequency and severity of infections did not differ across age (p=0.4 and p=0.2). CFS however associated with infections in frequency and severity (p=0.01 and p<0.001, Figure 1).

Conclusion

An initial frailty assessment at the time of diagnosis might assist in predicting infections in patients with newly diagnosed ANCA GN.

Funding

• Government Support – Non-U.S.