Background/Purpose: ANCA-associated vasculitis (AAV) is a rare systemic autoimmune disease with varying reports of incidence rates and clinical manifestations. Renal involvement is one of the most common manifestations and it can potentially progress to end-stage renal disease (ESRD). This study investigated the incidence rate and renal survival rate of patients with AAV using national health database in Korea.

Methods: Data were collected from the Korean National Health Insurance Claims Database. Incident AAV cases, according to the previously validated case-finding algorithm of AAV, between January 2010 to December 2019 were identified. Inverse probability treatment weights based on propensity scores and Cox’s regression analysis were used to calculate the renal survival rate of patients with AAV and compared to that of the patients with primary glomerulonephritis (PGN) and among disease subgroups.

Results: We identified a total of 2,048 AAV patients, consisting of 876 granulomatosis with polyangiitis (GPA), 646 eosinophilic granulomatosis with polyangiitis (EGPA) and 526 microscopic polyangiitis (MPA) and 57,549 patients with PGN. The percentage of patients with renal replacement treatment (RRT) in AAV was 20.5% (n=419), consisting of 18.7%, 4.5%, and 43% in GPA, EGPA and MPA, respectively. A total of 33,931 (59%) patients underwent RRT in PGN. The overall risk of ESRD was significantly lower in AAV group (hazard ratio [HR] 0.3, p< 0.001) compared to the PGN group after adjusting for age and sex. Among AAV subtypes, renal survival rate was superior in the order of EGPA, GPA and MPA (HR 0.08, 0.29, and 0.9, respectively and all p-values were < 0.001) compared to that of PGN.

Conclusion: A considerable number of AAV patients required RRT. Renal survival rate of AAV was favorable compared to PGN.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/renal-survival-rate-of-anca-associated-vasculitis-in-korea-a-nationwide-population-based-study-using-claims-data/