Small vessels vasculitis (SVV) is one of the cause of severe acute renal failure leading to end-stage renal disease. The current study investigates factors that can predict dialysis dependence in renal vasculitis.
All consecutive renal SVV patients, newly diagnosed at S.Orsola Malpighi Hospital of Bologna from January 1988 to May 2008, were eligible.
43 renal SVV patients with a 24-month follow-up were included. Demographics and clinical characteristics are described in Table 1. All patients received immunosuppressive therapy plus intravenous methylprednisolone, plasma exchange, or both. The predictive value of the clinical and laboratory parameters for renal outcomes (haemodialysis at discharge and at 24 months) was analyzed.
Table 1 | Characteristics of patients
No of patients
43
Gender (M:F)
19:24
Mean age (yrs)
60±16
No of pANCA+: cANCA+: ANCA -
21:17:5
No of organs involved
3±1
Mean CRP
8±9
At entry, 19/43 (44.2%) patients needed dialysis session; at discharge, 12/43 (27.9%) were dialysis dependent. At a two-year follow-up, 2/12 (16.7%) recovered renal function; of those dialysis free patients, 3/31 (9.7%) became dialysis dependent. 2/43 (4.6%) died at 14 and 18 months from diagnosis, respectively. Causes of death were cardiovascular diseases. Factors independently associated with haemodialysis at discharge and two years were serum creatinine at entry (P<0.05) and diuresis < 500 ml (P<0.05). None correlation was found with ANCA titer and/or positivity, CRP levels and haemoglobin.
In conclusion, serum creatinine and diuresis at entry are the only predictor factors of dialysis dependence at 24 months in patients affected from small vessels vasculitis.
