Prognosis And Risk Factors For Antineutrophil Cytoplasmic Antibody-associated Vasculitis Patients On Maintaining Dialysis

ObjectiveTo study the prognosis and risk factors for antineutrophil cytoplasmic antibody-associated vasculitis(AAV)patients on maintaining dialysis.MethodsWe retrospectively analyzed the data of AAV patients on maintaining dialysis that were treated and followed up at the First Affiliated Hospital of Zhejiang University Medical College from June 2008 to June 2016.We compared the rates of different organ involvement according the type of ANCA and compared the outcomes including infection and survival according to the types of dialysis as hemodialysis(HD)or peritoneal dialysis(PD).Then we use Kaplan-Meier method and Cox regression model to analyze the survival rates and risk factors of these patients.ResultsA total of 123 AAV patients on maintaining dialysis were enrolled,including 35 PD patients(28.5%)and 88 HD patients(71.5%),with an average dialysis duration of 1005±738 days.The median follow-up time is 34 months,39 cases(31.7%)were died.The main causes of death were infection and cardiovascular events.According to ANCA type grouping,patients with positive C-ANCA were more likely to develop eye damage.According to dialysis grouping,HD patients had higher incidence of lung infection.Single factor K-M survival analysis revealed that the survival rate was not statistically different between HD patients and PD patients.COX regression analysis showed that patients older than 65 years old,with cardiovascular disease and interstitial pneumonia at the dialysis onset were independent risk factors for worse outcome.ConclusionsThe survival rate of AAV patients was not statistically different between HD or PD therapy.Infections and cardiovascular events were major causes of death in these patients.Age older than 65 years,histories of pre-dialysis cardiovascular disease and pre-dialysis interstitial pneumonia were independent risk factors for worse outcomes.