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).