Association between longitudinal ANCA patterns and renal prognosis
In our series, 21 out of 26 patients with worsening renal function, 10 out of 11 patients with ESRD during follow-up, and 7 out of 8 patients with ESRD at baseline had anti-MPO antibodies (Table 1).
Due to the scarcity of patients with anti-PR3 AAV who developed renal failure in our series, we focused our analysis of renal outcomes on patients with anti-MPO antibodies, regardless they were diagnosed with GPA or MPA. In the univariate analysis, we found that patients with arthritis, fever or constitutional symptoms had a lower risk of worsening renal function than patients without these clinical manifestations (Table 5). In addition, patients with the combined R/P pattern had significantly worse renal prognosis than patients with the combined M/R pattern (Fig 2).
In the multivariate Cox regression analysis, both the recurrent ANCA pattern, or the combined R/P ANCA pattern were associated with an increased risk of worsening renal failure. The presence of arthritis or constitutional symptoms were associated with better renal outcomes. Neither the clinical diagnosis, nor the antigenic specificity were associated with an increased risk of worsening renal failure (Table 6).