Hepatic steatosis index at diagnosis has the potential for forecasting end-stage kidney disease in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Abstract

Objective This study evaluated whether the hepatic steatosis index (HSI) at antineutrophil cytoplasmic antibody-associated vasculitis (AAV) diagnosis could forecast poor outcomes during the disease course in AAV patients. Methods This study included 260 AAV patients. The equation for HSI is as follows HSI=8×(alanine aminotransferase/aspartate aminotransferase)+body mass index+(2, diabetes mellitus)+(2, female). The cut-off of HSI was obtained using the receiver operating characteristic curve. Results The median age of the 260 patients was 59.5 years, and 65.0% were female. Among the continuous variables excluding the parameters composing the equation for HSI, HSI was significantly correlated with Birmingham vasculitis activity score, five-factor score, haemoglobin, blood urea nitrogen, serum creatinine, and total cholesterol. Among poor outcomes, the area under the curve of HSI for end-stage renal disease (ESRD) was significant, and the cut-off of HSI for ESRD was set at ≤30.82. AAV patients with HSI ≤30.82 exhibited a significantly higher risk of ESRD (relative risk 3.489) and a significantly lower cumulative ESRD-free survival rate than those with HSI >30.82. Conclusion This study is the first to demonstrate that HSI at AAV diagnosis could forecast ESRD during the disease course in AAV patients.

Comparative Effectiveness and Safety of Biologic Treatments in Giant Cell Arteritis: A Network Meta-analysis of Randomized Controlled Trials

“…2,3 Significant negative consequences such as an increased risk of infection, osteoporosis, and diabetes are associated with long-term steroid use. [4][5][6] In recent years, there has been an increased interest in the use of biological therapies for the treatment of GCA in patients who cannot tolerate years. 7 Several randomized controlled trials on biological treatments for GCA, including tocilizumab, mavrilimumab, abatacept, and tumor necrosis factor (TNF) inhibitors have been reported.…”