A retrospective study on the outcomes of MPO-ANCA-associated vasculitis in dialysis-dependent patients

Midori Hasegawa, Kyoko Hattori, Satoshi Sugiyama, Hiroaki Asada, Hiroshi Yamashita, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Waichi Sato, Yukio Yuzawa

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives. This study investigated the clinical course of myeloperoxidase-antineutrophil cytoplasm autoantibody (MPO-ANCA)-associated vasculitis after starting dialysis.Methods. A retrospective review was conducted of the clinical charts of dialysis-dependent patients with MPO-ANCA-associated vasculitis who attended one of 8 associated clinics over the past 21 years.Results. Eighty-nine patients were included in the study; 88 had microscopic polyangiitis (MPA) and 1 had granulomatosis with polyangiitis. Of the 88 patients with MPA, 18 had renal-limited vasculitis. Twenty-one relapses occurred among 13 patients (frequency, 0.05 relapses/person-year; 95% confidence interval, 0.03-0.08). Mean time from start of dialysis to relapse was 65 ± 59 months. Cox multivariate analysis showed that pulmonary involvement was a predictor of relapse (hazard ratio [HR], 21.4) and mortality (HR, 4.60), and that patient age (HR, 1.10) and cyclophosphamide use (HR, 0.20) were significant predictors of mortality. Postdialysis 1- and 5-year survival rates were 83.0% and 65.6%, respectively; infection was the most frequent cause of death.Conclusion. Pulmonary involvement was a predictor of relapse and mortality. Although relapse can occur long after the start of dialysis, incidence was low among dialysis-dependent patients. Prolonged maintenance immunosuppressive therapy might be limited to patients with pulmonary involvement in dialysis-dependent ANCA-associated vasculitis.

Original languageEnglish
Pages (from-to)110-114
Number of pages5
JournalModern Rheumatology
Volume26
Issue number1
DOIs
Publication statusPublished - 02-01-2016

Fingerprint

Vasculitis
Autoantibodies
Peroxidase
Dialysis
Cytoplasm
Retrospective Studies
Recurrence
Microscopic Polyangiitis
Lung
Mortality
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Granulomatosis with Polyangiitis
Immunosuppressive Agents
Cyclophosphamide
Cause of Death
Multivariate Analysis
Survival Rate
Maintenance
Confidence Intervals
Kidney

All Science Journal Classification (ASJC) codes

  • Rheumatology

Cite this

Hasegawa, Midori ; Hattori, Kyoko ; Sugiyama, Satoshi ; Asada, Hiroaki ; Yamashita, Hiroshi ; Takahashi, Kazuo ; Hayashi, Hiroki ; Koide, Shigehisa ; Sato, Waichi ; Yuzawa, Yukio. / A retrospective study on the outcomes of MPO-ANCA-associated vasculitis in dialysis-dependent patients. In: Modern Rheumatology. 2016 ; Vol. 26, No. 1. pp. 110-114.
@article{609f108676534ca5b8a035b7c0149aac,
title = "A retrospective study on the outcomes of MPO-ANCA-associated vasculitis in dialysis-dependent patients",
abstract = "Objectives. This study investigated the clinical course of myeloperoxidase-antineutrophil cytoplasm autoantibody (MPO-ANCA)-associated vasculitis after starting dialysis.Methods. A retrospective review was conducted of the clinical charts of dialysis-dependent patients with MPO-ANCA-associated vasculitis who attended one of 8 associated clinics over the past 21 years.Results. Eighty-nine patients were included in the study; 88 had microscopic polyangiitis (MPA) and 1 had granulomatosis with polyangiitis. Of the 88 patients with MPA, 18 had renal-limited vasculitis. Twenty-one relapses occurred among 13 patients (frequency, 0.05 relapses/person-year; 95{\%} confidence interval, 0.03-0.08). Mean time from start of dialysis to relapse was 65 ± 59 months. Cox multivariate analysis showed that pulmonary involvement was a predictor of relapse (hazard ratio [HR], 21.4) and mortality (HR, 4.60), and that patient age (HR, 1.10) and cyclophosphamide use (HR, 0.20) were significant predictors of mortality. Postdialysis 1- and 5-year survival rates were 83.0{\%} and 65.6{\%}, respectively; infection was the most frequent cause of death.Conclusion. Pulmonary involvement was a predictor of relapse and mortality. Although relapse can occur long after the start of dialysis, incidence was low among dialysis-dependent patients. Prolonged maintenance immunosuppressive therapy might be limited to patients with pulmonary involvement in dialysis-dependent ANCA-associated vasculitis.",
author = "Midori Hasegawa and Kyoko Hattori and Satoshi Sugiyama and Hiroaki Asada and Hiroshi Yamashita and Kazuo Takahashi and Hiroki Hayashi and Shigehisa Koide and Waichi Sato and Yukio Yuzawa",
year = "2016",
month = "1",
day = "2",
doi = "10.3109/14397595.2015.1045255",
language = "English",
volume = "26",
pages = "110--114",
journal = "Modern Rheumatology",
issn = "1439-7595",
publisher = "Springer Japan",
number = "1",

}

A retrospective study on the outcomes of MPO-ANCA-associated vasculitis in dialysis-dependent patients. / Hasegawa, Midori; Hattori, Kyoko; Sugiyama, Satoshi; Asada, Hiroaki; Yamashita, Hiroshi; Takahashi, Kazuo; Hayashi, Hiroki; Koide, Shigehisa; Sato, Waichi; Yuzawa, Yukio.

In: Modern Rheumatology, Vol. 26, No. 1, 02.01.2016, p. 110-114.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A retrospective study on the outcomes of MPO-ANCA-associated vasculitis in dialysis-dependent patients

AU - Hasegawa, Midori

AU - Hattori, Kyoko

AU - Sugiyama, Satoshi

AU - Asada, Hiroaki

AU - Yamashita, Hiroshi

AU - Takahashi, Kazuo

AU - Hayashi, Hiroki

AU - Koide, Shigehisa

AU - Sato, Waichi

AU - Yuzawa, Yukio

PY - 2016/1/2

Y1 - 2016/1/2

N2 - Objectives. This study investigated the clinical course of myeloperoxidase-antineutrophil cytoplasm autoantibody (MPO-ANCA)-associated vasculitis after starting dialysis.Methods. A retrospective review was conducted of the clinical charts of dialysis-dependent patients with MPO-ANCA-associated vasculitis who attended one of 8 associated clinics over the past 21 years.Results. Eighty-nine patients were included in the study; 88 had microscopic polyangiitis (MPA) and 1 had granulomatosis with polyangiitis. Of the 88 patients with MPA, 18 had renal-limited vasculitis. Twenty-one relapses occurred among 13 patients (frequency, 0.05 relapses/person-year; 95% confidence interval, 0.03-0.08). Mean time from start of dialysis to relapse was 65 ± 59 months. Cox multivariate analysis showed that pulmonary involvement was a predictor of relapse (hazard ratio [HR], 21.4) and mortality (HR, 4.60), and that patient age (HR, 1.10) and cyclophosphamide use (HR, 0.20) were significant predictors of mortality. Postdialysis 1- and 5-year survival rates were 83.0% and 65.6%, respectively; infection was the most frequent cause of death.Conclusion. Pulmonary involvement was a predictor of relapse and mortality. Although relapse can occur long after the start of dialysis, incidence was low among dialysis-dependent patients. Prolonged maintenance immunosuppressive therapy might be limited to patients with pulmonary involvement in dialysis-dependent ANCA-associated vasculitis.

AB - Objectives. This study investigated the clinical course of myeloperoxidase-antineutrophil cytoplasm autoantibody (MPO-ANCA)-associated vasculitis after starting dialysis.Methods. A retrospective review was conducted of the clinical charts of dialysis-dependent patients with MPO-ANCA-associated vasculitis who attended one of 8 associated clinics over the past 21 years.Results. Eighty-nine patients were included in the study; 88 had microscopic polyangiitis (MPA) and 1 had granulomatosis with polyangiitis. Of the 88 patients with MPA, 18 had renal-limited vasculitis. Twenty-one relapses occurred among 13 patients (frequency, 0.05 relapses/person-year; 95% confidence interval, 0.03-0.08). Mean time from start of dialysis to relapse was 65 ± 59 months. Cox multivariate analysis showed that pulmonary involvement was a predictor of relapse (hazard ratio [HR], 21.4) and mortality (HR, 4.60), and that patient age (HR, 1.10) and cyclophosphamide use (HR, 0.20) were significant predictors of mortality. Postdialysis 1- and 5-year survival rates were 83.0% and 65.6%, respectively; infection was the most frequent cause of death.Conclusion. Pulmonary involvement was a predictor of relapse and mortality. Although relapse can occur long after the start of dialysis, incidence was low among dialysis-dependent patients. Prolonged maintenance immunosuppressive therapy might be limited to patients with pulmonary involvement in dialysis-dependent ANCA-associated vasculitis.

UR - http://www.scopus.com/inward/record.url?scp=84952006987&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84952006987&partnerID=8YFLogxK

U2 - 10.3109/14397595.2015.1045255

DO - 10.3109/14397595.2015.1045255

M3 - Article

VL - 26

SP - 110

EP - 114

JO - Modern Rheumatology

JF - Modern Rheumatology

SN - 1439-7595

IS - 1

ER -