Dr Georgina Oakman1,2, Dr Cindy Bach1, Dr Cindy Ong1
1Bendigo Health, Bendigo, 3550, 2Austin Health , Heidelberg, 3084
Aim:
To describe the clinical characteristics and outcomes of patients with biopsy-proven ANCA-associated glomerulonephritis at a regional health service in Victoria.
Background:
Rapidly progressive glomerulonephritis is a potentially devastating sequela of ANCA-associated vasculitis. There is currently limited Australian data on patients with ANCA-associated glomerulonephritis, particularly in a regional setting.
Methods:
We conducted a retrospective review of all renal biopsies performed at Bendigo Health between 1/1/2013 and 31/12/2021. Cases of newly diagnosed ANCA-associated glomerulonephritis were included. ANCA-negative glomerulonephritis was excluded. Information about treatment and follow-up was extracted from clinical records. A catchment population of 320 878 people and the Poisson distribution were used to estimate regional disease incidence.
Results:
27 cases of new ANCA-associated glomerulonephritis were identified. The calculated disease incidence in our region was 9.3 cases per million person-years (95% CI 6.2 – 13.6). The median age at diagnosis was 67 years (IQR 56 – 77 years). 59% of patients (n = 16) were diagnosed with microscopic polyangiitis and 41% (n = 11) with granulomatosis with polyangiitis. 2 patients had overlap Goodpasture syndrome. Treatment data was available for 25 patients. Most received intravenous methylprednisolone (96%) and cyclophosphamide (89%). 2 patients underwent plasma exchange. The median follow-up time was 38 months (IQR 21 – 65 months). Approximately one quarter of patients relapsed (n = 7) with a median time to relapse of 23 months (IQR 19 – 27 months). 19% of patients (n = 5) required ongoing renal replacement therapy. 3 patients (11%) died.
Conclusions:
Renal involvement in ANCA-associated vasculitis continues to carry significant morbidity and mortality. Our local disease incidence is comparable to that published by the handful of other Australian epidemiological studies.
Biography:
Bio to come