Entwicklung von Morbidität und Mortalität bei ANCA-assoziierten Vaskulitiden

Reinhold‐Keller, E.; Moosig, Frank

doi:10.1007/s00393-011-0756-z

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…7,8 Older age and the presence of comorbidity have been shown as risk factors for infection. 9 In our study, no relationship was found between the age, gender and hospitalization. In the study of Ofer-Shiber et al, the presence of comorbidity at the time of diagnosis of AAV was associated with lower patient and kidney survival.…”

Section: Discussioncontrasting

confidence: 63%

Infections and causative microorganisms in patients with ANCA-associated vasculitis

VARKAL

Türk

AĞBUGA

et al. 2023

Cukurova Medical Journal

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Purpose: The aim of this study was to detect infections requiring hospitalization in patients with ANCA-associated vasculitis (AAV). Materials and Methods: This is a single-center, retrospective study conducted in Turkish patients with AAV. Infection episodes requiring hospitalization, reproducing pathogens, laboratory findings, immunosuppressive treatments given for the treatment of vasculitis, and the relationship with the infection were evaluated. Results: Seventy-four patients diagnosed with AAV were included in the study. Hospitalization due to infection was observed in 36 of the patients. The coexistence of diabetes mellitus (DM) was found to be significantly higher in the infected patient group. Cyclophosphamide (CYC) treatment found to increase risk of infection. More than 80% of the infected patient group presented with renal involvement (80.6%). A total of 68 infectious episodes were seen in 36 patients. The most common involvement of infection was the respiratory tract with a rate of 70.6%. Gram-negative bacteria were the most common pathogen, especially Pseudomonas aeruginosa. With the effect of the pandemic, SARS-CoV-2 has come to the fore among viral infections. Aspergillosis was the most frequently detected among fungal infections. Besides, aspergillosis was the cause of 85.7% (6 episodes) of fungal infections. Lymphopenia was observed in 76.5% of the infection episodes. 57.4% of infections developed in the first year of the induction therapy. The most frequently used immunosuppressive therapy for the treatment of vasculitis in infectious episodes was CYC (41.2%). Conclusion: Managing infections during the vasculitis treatment is crucially important. Lymphopenia, kidney involvement, DM and immunosuppressive therapy are factors that increase the risk of infection. Clinicians should take preventive measure especially for respiratory tract infections and gram-negative bacteria as pathogens.

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Section: Discussioncontrasting

confidence: 63%

Infections and causative microorganisms in patients with ANCA-associated vasculitis

VARKAL

Türk

AĞBUGA

et al. 2023

Cukurova Medical Journal

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“…Overall, this work shows that the risk of serious infection or cardiovascular event far exceeds the risk of vasculitis relapse in patients with ANCA-associated vasculitis on long-term dialysis, with an increasing rate of patients in 10) 5 (14) There was no significant difference between granulomatosis with polyangiitis and microscopic polyangiitis. Results are expressed as n (%).…”

Section: Event-free Survival (95% Ci)mentioning

confidence: 70%

“…Infections are a major cause of morbidity and mortality both in patients with vasculitis (13,14) and in patients with kidney failure (15,16). The use of a central venous catheter, the frailty of some patients, and the immunodeficiency typically attributed to uremia may contribute to this susceptibility (17).…”

Section: Introductionmentioning

confidence: 99%

Disease Activity and Adverse Events in Patients with ANCA-Associated Vasculitides Undergoing Long-Term Dialysis

Kauffmann

Bobot

Robert

et al. 2021

CJASN

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Background and objectivesKidney impairment of ANCA-associated vasculitides can lead to kidney failure. Patients with kidney failure may suffer from vasculitis relapses but are also at high risk of infections and cardiovascular events, which questions the maintenance of immunosuppressive therapy.Design, setting, participants, & measurementsPatients with ANCA-associated vasculitides initiating long-term dialysis between 2008 and 2012 in France registered in the national Renal Epidemiology and Information Network registry and paired with the National Health System database were included. We analyzed the proportion of patients in remission off immunosuppression over time and overall and event-free survival on dialysis (considering transplantation as a competing risk). We compared the incidence of vasculitis relapses, serious infections, cardiovascular events, and cancers before and after dialysis initiation.ResultsIn total, 229 patients were included: 142 with granulomatous polyangiitis and 87 with microscopic polyangiitis. Mean follow-up after dialysis initiation was 4.6±2.7 years; 82 patients received a kidney transplant. The proportion of patients in remission off immunosuppression increased from 23% at dialysis initiation to 62% after 5 years. Overall survival rates on dialysis were 86%, 69%, and 62% at 1, 3, and 5 years, respectively. Main causes of death were infections (35%) and cardiovascular events (26%) but not vasculitis flares (6%). The incidence of vasculitis relapses decreased from 57 to seven episodes per 100 person-years before and after dialysis initiation (P=0.05). Overall, during follow-up, 45% of patients experienced a serious infection and 45% had a cardiovascular event, whereas 13% experienced a vasculitis relapse.ConclusionsThe proportion of patients with ANCA-associated vasculitis in remission off immunosuppression increases with time spent on dialysis. In this cohort, patients were far less likely to relapse from their vasculitis than to display serious infectious or cardiovascular events.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_11_08_CJN03190321.mp3

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