scholarly journals AB0820 INFLUENCE OF ANCA ANTIBODIES ON DEMOGRAPHIC AND CLINICAL CHARACTERISTIC OF AAV

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1434.1-1434
Author(s):  
K. Wójcik ◽  
A. Masiak ◽  
Z. Zdrojewski ◽  
R. Jeleniewicz ◽  
M. Majdan ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
Renal Involvement ◽  
Organ Involvement ◽  
Unknown Etiology ◽  
Anca Associated Vasculitis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Male To Female

Background:ANCA associated vasculitides (AAV) are a heterogeneous group of rare diseases with unknown etiology and the broad clinical spectrum ranging from life-threatening systemic disease, through single organ involvement to minor isolated skin changes. Unfortunately the clinical classification, ANCA specificity or genetic characteristics alone is not able to categorize AAV patients in a satisfactory manner. As a consequence advanced statistical techniques were used to identify and stratify AAV subphenotypes [1, 2]. Here we have analyzed influence of the ANCA type on clinical manifestations and demographic characteristics in various types of AAV, based on data from the POLVAS registryObjectives:We decided to retrospectively analyze a large cohort of Polish AAV patients deriving from several referral centers – members of the Scientific Consortium of the Polish Vasculitis Registry (POLVAS) – and concentrate on demographic and clinical characteristics of anti-PR3 and anti-MPO positive patients regardless of their clinical diagnosis.Methods:We conducted a systematic multicenter retrospective study of adult patients diagnosed with AAV between Jan 1990 and Dec 2016. Patients were enrolled by 9 referral centers. We analyzed dichotomous variables: gender; ANCA status – anti-PR3+ or anti-MPO+, ANCA negative; organ involvement - skin, eye, ENT, respiratory, heart, GI, renal, urinary, CNS, peripheral nerves and polytomous variable (number of relapses), supported by quantitative covariates (e.g., age at diagnosis, CRP at diagnosis, maximal serum creatinine concentration ever)[3].Results:MPO-positive patients (both GPA and EGPA phenotype) were older at the time of diagnosis with a substantial percentage diagnosed > 65 years of age, and with high rate of renal involvement. Interestingly, while in the whole group of patients diagnosed with EGPA male to female ratio was 1:2, the MPO+ EGPA patients showed M:F ratio of 1:1.The analysis of ANCA negative AAV reveled significant differences in GPA, ANCA negative group is characterized with significantly lower frequency of renal involvement compared to rest GPA (11,5% vs 63,7%) p<0,05 what should be emphasized ANCA negative AAV never lead to ESRD (end stage renal disease) or even transient dialysis.Conclusion:ANCA specificity is indispensable as a separate variable in any clinically relevant analysis of AAV subcategories. MPO+ group is characterized by older age at time of diagnosis, male to female ration 1:1, kidney involvement, and shows more homogenous clinical phenotype than PR3+ AAV patients. In our group ANCA negative AAV never lead to ESRD (end stage renal disease) or even transient dialysis.References:[1]Mahr A, Specks U, Jayne D. Subclassifying ANCA-associated vasculitis: a unifying view of disease spectrum. Rheumatol Oxf Engl 2019;58:1707–9. https://doi.org/10.1093/rheumatology/kez148.[2]Wójcik K, Biedroń G, Wawrzycka-Adamczyk K, Bazan-Socha S, Ćmiel A, Zdrojewski Z et al. Subphenotypes of ANCA-associated vasculitis identified by latent class analysis. Clin Exp Rheumatol. 2020 Sep 1. Epub PMID: 32896241.[3]Wójcik K, Wawrzycka-Adamczyk K, Włudarczyk A, Sznajd J, Zdrojewski Z, Masiak A, et al. Clinical characteristics of Polish patients with ANCA-associated vasculitides—retrospective analysis of POLVAS registry. Clinical Rheumatology. 1 wrzesień 2019;38(9):2553–63.Disclosure of Interests:None declared

Histopathological subgrouping versus renal risk score for the prediction of end-stage renal disease in ANCA-associated vasculitis

2020 ◽  
Vol 79 (5) ◽  
pp. 675-676 ◽  
Author(s):  
Onay Gercik ◽  
Emre Bilgin ◽  
Dilek Solmaz ◽  
Fulya Cakalagaoglu ◽  
Arzu Saglam ◽  
...  
Keyword(s):  
Renal Disease ◽  
Risk Score ◽  
End Stage Renal Disease ◽  
Anca Associated Vasculitis ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Clinical characteristics of bladder tumors in hemodialysis patients: Bladder tumors in end-stage renal disease patients

2019 ◽  
Vol 52 (11) ◽  
pp. 639-641
Author(s):  
Hirofumi Shimoyama ◽  
Masahiro Shimoyama ◽  
Akihisa Watanabe ◽  
Satoru Hirose ◽  
Riichi Kurane ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
Hemodialysis Patients ◽  
Bladder Tumors ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Emergency Department Use by Patients with End-stage Renal Disease in the United States

2020 ◽  
Author(s):  
Ningyuan Wang ◽  
Jiao Pei ◽  
Hui Fan ◽  
Yaseen Ali ◽  
Jian Zhao ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
The United States ◽  
Adult Age ◽  
Ed Visits ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD vs. those without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits were ESRD patients. ED patients with ESRD were mostly non-Hispanic whites (51.5%) and males were more likely to be ESRD patients than females (aOR: 1.48; 95% CI: 1.47–1.48). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.22; 95% CI: 2.21–2.22) and intensive care unit (ICU) (aOR: 1.53; 95% CI: 1.52–1.54) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests, get medical imaging tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.

scholarly journals Emergency Department Use by Patients With End-stage Renal Disease in the United States

2020 ◽  
Author(s):  
Ningyuan Wang ◽  
Jiao Pei ◽  
Hui Fan ◽  
Yaseen Ali ◽  
Jian Zhao ◽  
...  
Keyword(s):  
United States ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
The United States ◽  
Adult Age ◽  
Ed Visits ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background: We sought to describe the national characteristics of ED visits by patients with end-stage renal disease (ESRD) in the United States in order to improve the emergency treatment and screening of ESRD patients. Methods: We analyzed data from 2014-2016 ED visits provided by the National Hospital Ambulatory Medical Care Survey. We sampled adult (age ≥ 18 years) ED patients with ESRD. By proportion or means of weighted sample variables, we quantified annual ED visits by patients with ESRD. We investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with ESRD vs. those without ESRD. Logistic regression models were used to estimate the association between these characteristics and ESRD ED visits. Results: Approximately 722,692 (7.78%) out of 92,899,685 annual ED visits were ESRD patients. ED patients with ESRD were mostly non-Hispanic whites (51.5%) and males were more likely to be ESRD patients than females (aOR: 1.48; 95% CI: 1.47–1.48). ED patients with ESRD were more likely to be admitted to the hospital (aOR: 2.22; 95% CI: 2.21–2.22) and intensive care unit (ICU) (aOR: 1.53; 95% CI: 1.52–1.54) than patients without ESRD. ED patients with ESRD were more likely to receive blood tests, get medical imaging tests.Conclusion: We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with ESRD, using the most comprehensive, nationally representative study to date. These patients’ higher hospital and ICU admission rates indicate that patients with ESRD require a higher level of emergency care.

scholarly journals Clinical characteristics and outcomes of patients with end-stage renal disease hospitalized with diabetes ketoacidosis

2020 ◽  
Vol 8 (1) ◽  
pp. e000763 ◽  
Author(s):  
Rodolfo J Galindo ◽  
Francisco J Pasquel ◽  
Maya Fayfman ◽  
Katerina Tsegka ◽  
Neil Dhruv ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Renal Function ◽  
Length Of Stay ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Characteristics ◽  
Volume Overload ◽  
Chronic Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage

IntroductionThere is limited evidence to guide management in patients with end-stage renal disease (ESRD) on chronic hemodialysis admitted with diabetes ketoacidosis. Thus, we investigated the clinical characteristics and outcomes of patients with ESRD admitted with diabetic ketoacidosis (DKA).MethodsIn this observational study, we used International Classification of Diseases Ninth/Tenth Revision codes to identify adult (aged 18–80 years) patients admitted to Emory University Hospitals between 1 January 2006 and 31 December 2016. DKA and ESRD diagnoses were confirmed by reviewing medical records and by admission laboratory results.ResultsAmong 307 patients with DKA meeting the inclusion and exclusion criteria, 22.1% (n: 68) had ESRD on hemodialysis and 77.9% (n: 239) had preserved renal function (estimated glomerular filtration rate >60 mL/min/1.73 m2). Compared with patients with preserved renal function, the admission blood glucose was higher (804.5±362.6 mg/dL vs 472.5±137.7 mg/dL) and the mean hemoglobin A1c was lower (9.6%±2.1 vs 12.0%±2.5) in patients with DKA and ESRD, both p<0.001. The rates of hypoglycemia <70 mg/dL (34% vs 14%, p=0.002) and <54 mg/dL (13% vs 5%, p=0.04) were higher in the ESRD group. During hospitalization, more patients with ESRD develop volume overload (28% vs 3%, p<0.001) and require mechanical ventilation (24% vs 3%, p=<0.001). There were no differences in hospital mortality (3% vs 0%, p=0.21), but length of stay (median 7.0 vs 3.0 days, p<0.001) was longer in the ESRD cohort. After adjusting for multiple covariates, patients with DKA and ESRD have higher odds of hypoglycemia (OR 3.3, 95% CI 1.51 to 7.21, p=0.003) and volume overload (OR 4.22, 95% CI 1.37 to 13.05, p=0.01) compared with patients with DKA with preserved renal function.ConclusionsPatients with DKA and ESRD on chronic hemodialysis had worse clinical outcomes including higher rates of hypoglycemia, volume overload, need for mechanical ventilation and longer length of stay, compared with patients with preserved kidney function.

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