RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

BackgroundWe 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.MethodsSeventy patients diagnosed with ANCA-positive AAV from 2006 to 2019 at a single center were analyzed and categorized into younger (aged <65 years) or elderly (aged ≥65 years) groups. Initial induction treatments were investigated according to age group. All-cause mortality and kidney outcomes were evaluated.ResultsAfter categorization by age, 34 (48.6%) and 36 patients (51.4%) 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 a median follow-up of 14.6 months (range, 3.0-53.1 months), 13 patients died (elderly group: 11 patients, 84.6%). In the elderly group, older age (hazard ratio [HR], 1.44; 95% confidence interval [CI], 1.09-1.90; p = 0.01), 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 = 0.03) were significant risk factors for all-cause mortality after adjustment. Oral CYC + steroid treatment was associated with decreased all-cause mortality compared to untreated induction immunosuppressants (HR, 0.01; 95% CI, 0.0003-0.47; p = 0.02). Kidney failure or renal recovery outcomes were not significantly different between the younger and elderly groups.ConclusionPatients aged ≥65 years had higher mortality rates than younger patients, and mortality was associated with older age, lower hemoglobin, higher serum creatinine level, and nontreatment compared to oral CYC + steroids.

참고문헌 (Reference)

1 Zhu P, "The renal histopathology spectrum of elderly patients with kidney diseases : a study of 430 patients in a single Chinese center" 93 : e226-, 2014

2 Watts RA, "The contrasting epidemiology of granulomatosis with polyangiitis(Wegener’s)and microscopic polyangiitis" 51 : 926-931, 2012

3 Jones RB, "Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis : 2-year results of a randomised trial" 74 : 1178-1182, 2015

4 Stone JH, "Rituximab versus cyclophosphamide for ANCA-associated vasculitis" 363 : 221-232, 2010

5 de Groot K, "Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis : a randomized trial" 150 : 670-680, 2009

6 Harper L, "Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis : long-term follow-up" 71 : 955-960, 2012

7 Li ZY, "Predictors for outcomes in patients with severe ANCA-associated glomerulonephritis who were dialysis-dependent at presentation : a study of 89 cases in a single Chinese center" 42 : 515-521, 2013

8 임태훈 ; Sang-Un Kim ; 박상미 ; 임정훈 ; Hee-Yeon Jung ; Jang-Hee Cho ; Chan-Duck Kim ; 김용림 ; 한만훈 ; 김용진 ; 최지영 ; 박선희, "Patterns in renal diseases diagnosed by kidney biopsy: A single-center experience" 대한신장학회 39 (39): 60-69, 2020

9 Weiner M, "Outcome and treatment of elderly patients with ANCA-associated vasculitis" 10 : 1128-1135, 2015

10 Jones RB, "Mycophenolate mofetil versus cyclophosphamide for remission induction in ANCA-associated vasculitis : a randomised, non-inferiority trial" 78 : 399-405, 2019