대한신장학회

논문분류	춘계학술대회 초록집
제목	Clinical features and outcomes of elderly patients with antineutrophil cytoplasmic antibody-positive vasculitis: report from a single-center retrospective study
저자	Hyo Jin Kim, Miyeun Han, Sang Heon Song, Eun Young Seong
출판정보	2021; 2021(1):
키워드
초록	Objective: Seventy patients diagnosed with ANCA-positive AAV from 2006 to 2019 at a single center were analyzed and categorized into younger (age <65 years) and elderly (age ≥65 years) groups. Initial induction treatments and ANCA specificity (myeloperoxidase [MPO]/P-ANCA or proteinase 3 [PR3]/C-ANCA) were investigated according to age group. All-cause mortality and kidney outcomes were evaluated. Methods: After categorization by age, 34 (48.6%) and 36 (51.4%) patients were in the younger and elderly groups, respectively. In the elderly group, more patients were treated with oral cyclophosphamide (CYC) (30.6%) than with intravenous CYC (19.4%). During the median follow-up of 14.6 (range 3.0, 53.1) months, 13 patients died (elderly group, 11 [84.6%]). In the elderly group, older age (HR, 1.44; 95% CI, 1.09–1.90; P = 0.010), lower hemoglobin (HR, 0.21; 95% CI, 0.08–0.60; P=0.003), and higher serum creatinine level (HR 14.17; 95% CI, 1.29–155.84; P=0.030) were significant risk factors for all-cause mortality after adjustment. Oral CYC + steroid treatment was associated with decreased all-cause mortality compared to non-treatment (HR, 0.01; 95% CI, 0.0003–0.47; P = 0.018). Kidney failure or renal recovery outcomes were not significantly different between the younger and elderly groups. Results: Patients aged ≥65 years had higher mortality rates than younger patients, and mortality was associated with older age, lower hemoglobin, higher serum creatinine level, and non-treatment compared to oral CYC + steroid. Conclusions: Objective: We aimed to investigate the clinical characteristics and outcomes of patients aged ≥65 years with antineutrophil cytoplasmic autoantibody (ANCA)-positive ANCA associated vasculitis (AAV) in Korea. Methods: Seventy patients diagnosed with ANCA-positive AAV from 2006 to 2019 at a single center were analyzed and categorized into younger (age <65 years) and elderly (age ≥65 years) groups. Initial induction treatments and ANCA specificity (myeloperoxidase [MPO]/P-ANCA or proteinase 3 [PR3]/C-ANCA) were investigated according to age group. All-cause mortality and kidney outcomes were evaluated. Results: After categorization by age, 34 (48.6%) and 36 (51.4%) patients were in the younger and elderly groups, respectively. In the elderly group, more patients were treated with oral cyclophosphamide (CYC) (30.6%) than with intravenous CYC (19.4%). During the median follow-up of 14.6 (range 3.0, 53.1) months, 13 patients died (elderly group, 11 [84.6%]). In the elderly group, older age (HR, 1.44; 95% CI, 1.09–1.90; P = 0.010), lower hemoglobin (HR, 0.21; 95% CI, 0.08–0.60; P=0.003), and higher serum creatinine level (HR 14.17; 95% CI, 1.29–155.84; P=0.030) were significant risk factors for all-cause mortality after adjustment. Oral CYC + steroid treatment was associated with decreased all-cause mortality compared to non-treatment (HR, 0.01; 95% CI, 0.0003–0.47; P = 0.018). Kidney failure or renal recovery outcomes were not significantly different between the younger and elderly groups. Conclusions: Patients aged ≥65 years had higher mortality rates than younger patients, and mortality was associated with older age, lower hemoglobin, higher serum creatinine level, and non-treatment compared to oral CYC + steroid.
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