Long-term survival and mortality predictors in a Swedish cohort of patients with ANCA-positive vasculitis and severe kidney involvement

作者：Voudouri K, Östlund Y, Mihovilovic K, Bylund DK, Svensson MK, Saeed A · 发表于：Clinical kidney journal · 年份：2026 · DOI：10.1093/ckj/sfag159 · 被引用次数：32

INTRODUCTION: To describe the clinical characteristics of a Swedish cohort of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) and kidney involvement and to study long-term survival and predictors of all-cause mortality. METHODS: An observational study including patients with AAV and kidney involvement between 1993 and 2023 from two centres in mid-Sweden. Data were obtained from electronic health care records and follow-up visits. Multivariable Cox regression models and Kaplan-Meier analysis were performed to evaluate risk factors of interest predicting all-cause mortality. RESULTS: Among 190 patients (56% men, median age 67 years, 43% PR3-ANCA (Proteinase 3 Anti-Neutrophil Cytoplasmic Antibody), and 57% MPO -ANCA (Myeloperoxidase Anti-Neutrophil Cytoplasmic Antibody) positive, estimated glomerular filtration rate at diagnosis was 23 ml/min/1.73 m2 [interquartile range (IQR) 11-42] and 16% required dialysis. Median follow-up 20 was 7.5 years (IQR 3.6-12.3) and 106 deaths occurred. Main causes of death were infections (28%), cardiovascular disease (24%) and malignancy (18%). Cox hazard regression models showed that older age [hazard ratio (HR) 1.10, 95% CI 1.06-1.14] was a strong, consistent, and independent predictor of all-cause mortality, irrespective of sex, ANCA type, and kidney function. In the Uppsala cohort (n = 91) serum albumin levels at diagnosis emerged also as an independent risk factor when adjusting for age, kidney functi...