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Risk factors associated with relapse or infectious complications in Japanese patients with microscopic polyangiitis

Kiyoki Kitagawa1, Kengo Furuichi2,3,4, Akihiro Sagara5,6

  • 1Division of Internal Medicine, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.

Clinical and Experimental Nephrology
|November 22, 2015
PubMed
Abstract

Insights

Preventing relapse and infections in microscopic polyangiitis (MPA) with rapidly progressive glomerulonephritis (RPGN) is crucial. Disease activity and organ damage severity predict these complications, impacting patient prognosis.

Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Microscopic polyangiitis (MPA) with rapidly progressive glomerulonephritis (RPGN) requires effective remission maintenance therapy to prevent relapse and infection.
  • Identifying risk factors for relapse and infectious complications is essential for improving patient outcomes.

Purpose of the Study:

  • To examine clinicopathological characteristics of ANCA-positive MPA patients with RPGN.
  • To determine risk factors for relapse and infectious complications after remission induction therapy.

Main Methods:

  • Retrospective analysis of 52 ANCA-positive MPA patients with RPGN (2002-2012).
  • Clinicopathological findings were compared between patients with and without relapse or infectious complications.

Main Results:

  • High Vasculitis Damage Index (VDI) was a leading factor for relapse (HR 3.36).
  • Birmingham Vasculitis Activity Score, RPGN clinical grade at diagnosis, and VDI at remission were higher in the infectious group.
  • RPGN clinical grade at diagnosis was the leading factor for infectious complications (HR 5.30).

Conclusions:

  • Disease activity at diagnosis and organ damage severity at remission are associated with relapse and infections.
  • Infectious complications significantly affect kidney survival and all-cause mortality in ANCA-positive MPA with RPGN.
Keywords:
InfectionMicroscopic polyangiitis (MPA)PrognosisRapidly progressive glomerulonephritis (RPGN)Relapse

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