#2019 Association of anti-neutrophil cytoplasmic antibody (ANCA) serology and concentration with incidence, renal trajectories and mortality in ANCA-associated vasculitis

作者：Karl Emil Nelveg-Kristensen, Casper Rydahl, Cecilie Lyngsø, Bo Baslund, Per Ivarsen, Stine H. Finsen, Christian Torp‐Pedersen, Jon Waarst Gregersen, Wladimir Szpirt, Nicholas Carlson · 发表于：Nephrology Dialysis Transplantation · 年份：2025 · DOI：10.1093/ndt/gfaf116.0204 · 研究领域：Vasculitis and related conditions、Otitis Media and Relapsing Polychondritis、Neutrophil, Myeloperoxidase and Oxidative Mechanisms

Abstract Background and Aims Differences in renal outcomes and prognosis between the two main serotypes of AAV, PR3-AAV and MPO-AAV, are not fully understood. This study examined the incidence, age distribution, mortality, and longitudinal changes in renal function around diagnosis, with a focus on the impact of initial ANCA concentrations. Method Patients with incident MPO- and PR3-AAV (ICD-10 and serology) from 2010 to 2023 were identified using Danish nationwide registries. Incidence was reported as cases/million/year. Kidney function was assessed by creatinine (µmol/L) and eGFR (ml/min, CKD-EPI formula). PR3- and MPO-ANCA levels (kU/L) were dichotomized by median. Kaplan-Meier analyses estimated mortality rates. Results A total of 1,781 AAV patients were identified (48.2% female; median age 65 [IQR 21]). Of these, 1,072 (60.2%) had PR3-AAV (46.6% female; median age 63 [IQR 22]), 662 (37.2%) had MPO-AAV (49.5% female; median age 68 [IQR 18]), 20 (1.1%) had PR3-MPO double positivity (55% female; median age 63 [IQR 20.5]), and 27 (1.5%) had ANCA-anti-GBM double positivity (74.1% female; median age 71 [IQR 20]). Overall incidence was 23.8 (SD 3.4), with no significant change over the study period for PR3-AAV (14.8 [SD 6.7]) and MPO-AAV (9.4 [SD 3.6]). The proportion of patients with eGFR ≤60 was significantly greater in MPO-AAV both one year prior (20.9% vs 13.2%, p < 0.001) and one year after diagnosis (62.3% vs 34.3%, p < 0.001) compared to PR3-AAV. Overall, o...