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Comparison of the factors associated with the short-term prognosis between elderly and non-elderly patients with anti-neutrophil cytoplasmic antibody-associated vasculitis: a retrospective observational study


1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan. tokomadaraha724@gmail.com
  2. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan.
  3. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan.
  4. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan.
  5. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan.
  6. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan.
  7. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan.
  8. Department of Nephrology, Nagano Red Cross Hospital, Nagano, Japan.
  9. Department of Nephrology, Nagano Red Cross Hospital, Nagano, Japan.
  10. Department of Nephrology, Shinshu University Hospital, Matsumoto, Japan. yujibeat@shinshu-u.ac.jp

CER14649
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PMID: 34524078 [PubMed]

Received: 19/03/2021
Accepted : 21/06/2021
In Press: 09/09/2021

Abstract

OBJECTIVES:
The difference in factors associated with the prognosis between elderly and non-elderly patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is uncertain. We aimed to elucidate the clinical factors associated with the short-term prognosis (within 6 months from the start of the treatment) and investigate the differences in the associated factors between elderly and non-elderly individuals.
METHODS:
We performed a dual centre retrospective observational study of patients newly treated with AAV (eosinophilic granulomatous with polyangiitis was excluded). The primary outcome was all-cause death, and the secondary outcome was end-stage renal disease (ESRD) and infectious complications within 6 months after the start of treatment. We analysed factors associated with these outcomes using logistic regression analyses.
RESULTS:
Of the 79 patients, patients aged ≥75 years were defined as elderly (n=41), whereas those aged <75 years were de¬fined as non-elderly (n=38). In elderly patients, age was significantly associated with all-cause mortality. In the non-elderly patients, the geriatric nutritional risk index was significantly associated with all-cause death. The estimated glomerular filtration rate (eGFR) before the start of treatment was significantly associated with ESRD in elderly and non-elderly patients. In elderly patients, the Birmingham vasculitis score 3, eGFR, methylprednisolone pulse use, and cyclophosphamide use were significantly associated with infectious complications. Factors other than the serum albumin level were not significantly associated with infectious complications in the non-elderly population.
CONCLUSIONS:
The factors associated with all-cause death and infectious complications differed between elderly and non-elderly patients. Awareness of these differences may contribute to better management of AAV.

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