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MO134: Follow-Up of Patients with Vasculitis: A 10-year retrospective study


 
 
 Vasculitis constitutes a systemic disease with renal involvement at almost 100% in microscopic polyangiitis, 70–80% in granulomatosis with polyangitiis, 25% in eosinophilic granulomatosis with polyangitiis and 40–50% appears as renal limited vasculitis. In order to describe our experience, we conducted a retrospective study of patients with vasculitis which we have been monitoring for the last 10 years.
 
 
 
 We studied the time of the remission, the use of plasma exchange (PLEX), the biopsy results as well as the time between the first symptoms and the initiation of the therapy.
 
 
 
 The total number of patients was 59, 28 (47.5%) females, with a mean age of 66.08 ± 13.95 years. The median follow-up time was 70 weeks with IQR [64, 76]. The patients with positive pANCA/MPO were 38 (64.4%), while those with positive cANCA/PR3 were 10 (16.9%). The remaining nine patients (15.3%) suffered from ANCA negative vasculitis. The mean value of the initial creatinine was 4.53 ± 2.3 mg/dL and the median value of the eGFR CKD-EPI was 11 mL/min/1.73 m2, IQR [7, 17]. The PLEX was implemented auxiliary in 16 patients (27.1%) and in 32 patients (54.2%) pulse cortisone along with intravenous cyclophosphamide was preferred. The remission was accomplished in 32 patients (54.2%) with median time of 8 weeks, IQR [0, 17]. At least one relapse episode was noted in 8 patients (13.6%), 19 patients (32.2%) ended up in ESRD and 15 patients (25.4%) deceased during the follow-up time. The major cause of death was sepsis with 10 demises (66.7%), while 5 patients (8.4%) suffered from malignancies in general. The remission time was found to be dependent on the initial value of creatinine (P-value.023). There was no statistical significance regarding the findings of the biopsy and the outcome, the relapse rate or the remission time. There was also no correlation marked between the first symptoms and the initiation of the therapy. The plasma exchange failed to reduce the time until the remission, unless the patient was cANCA positive (P-value.036). Although the sample was limited, the patients with positive cANCA/PR3 submitted to PLEX were able to achieve the remission in 5.25 weeks contrary to those who received solely methylprednisolone and cyclophosmamide. The latter achieved remission in 21 (mean) weeks (LogRank test, P-vaue .001. The vasculitis type has no effect over the renal outcome or the relapse rate. No statistical significance was found between the PLEX and the relapse rate or the outcome. Patients do not benefit from auxiliary treatment with the PLEX, unless they have positive cANCA/PR3. However, the initial serum creatinine seems to affect the time of the remission.
 
 
 
 There is indisputable need for a larger patient sample in order to safely conduct further results.
