Outcome and risk factors of patients with renal failure due to ANCA-associated vasculitis after emergency hemodialysis

doi:10.16150/j.1671-2870.2017.04.008

Abstract

Abstract: Objective: To analyze the outcome and risk factors of patients with renal failure due to ANCA-associated vasculitis(AAV) after emergency hemodialysis. Methods: The clinical data of patients diagnosed as renal failure due to AAV and treated with emergency hemodialysis from Jan. 2006 to Jan.2016 were recruited, and the outcome (renal reco-very, death within 3 months, maintenance dialysis) and risk factors were analyzed. The survival patients who came into maintaining dialysis were divided into two groups: the peritoneal dialysis group and hemodialysis group. Results: A total of 58 patients were enrolled. Renal function of 9 patients recovered after emergency hemodialysis; 24 patients died within 3 months, and the main causes of death were pneumonia and disease activity. The patients died had older age (P=0.001), higher BVAS scores (P=0.048), lower level of platelets (P=0.004) than that of survival patients. Logistic regression analysis showed that old age (OR=1.087, 95% CI: 1.014-1.165), high BVAS scores (OR=1.160, 95% CI: 1.005-1.339), low level of platelets (OR=1.011, 95% CI: 1.002-1.021 ) were risk factors for early death. Twenty-five patients came into maintaining dialysis, including 10 cases with peritoneal dialysis (PD) and 15 cases with hemodialysis (HD). At 6 months after dialysis, BVAS scores of PD group reduced from baseline 15 (13,18) to 2 (2,4) (P=0.001); BVAS scores of HD group decreased from baseline 16 (14,21) to 4 (2,6) (P=0.001). There were no significant differences in hemoglobin, serum albumin between the two groups at 6 months, 1 year and 2 years (P>0.05). Two HD patients and four PD patients died during follow-up, and pneumonia was the main cause of death. The difference in long-term survival rate between the two groups was not significant (P=0.235). Conclusions: Old age, high BVAS scores, low level of platelets are risk factors for death of patients with renal failure due to AAV in early period. On maintaining dialysis, the control of vasculitis activity and long-term survival rate are similar between HD and PD groups. Pneumonia is the main cause of death both in early period and on maintai-ning dialysis.

Key words: ANCA-associated vasculitis, Renal failure, Emergency dialysis, Outcome

CLC Number:

R692.5

XING Peng, LIU Simeng, CHEN Zijin, REN Hong, CHEN Xiaonong, LI Xiao. Outcome and risk factors of patients with renal failure due to ANCA-associated vasculitis after emergency hemodialysis[J]. Journal of Diagnostics Concepts & Practice, 2017, 16(04): 384-389.

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