Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany.
Institute of Pathology, University Medical Center, Göttingen, Germany.
Sci Rep. 2022 Nov 4;12(1):18736. doi: 10.1038/s41598-022-23313-7.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a small vessel vasculitis often leading to critical illness by multi-organ failure. Data for patients with specifically ANCA-associated renal vasculitis requiring intensive care unit (ICU) supportive care are limited and have mainly focused on long-term renal and overall outcome. Particularly, data on critical illness during the initial course of disease are scarce and remain poorly determined. Therefore, the purpose of this retrospective study was to identify predictors of critical illness in a cohort of patients with ANCA-associated renal vasculitis. We retrospectively included a total number of 53 cases with confirmed ANCA-associated renal vasculitis between 2015 till 2020 in a single-center cohort study. We here identified an association between low hemoglobin levels and requirement of ICU supportive care in patients with ANCA-associated renal vasculitis. Furthermore, levels of hemoglobin below 9.8 g/dL at admission independently predicted prolonged requirement of ICU supportive care in critically ill patients with ANCA-associated renal vasculitis. These findings confirm that low levels of hemoglobin negatively affect short-term outcome and could further improve our current understanding for the role of anemia in ANCA-associated renal vasculitis.
抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AAV）是一种小血管血管炎，常因多器官衰竭导致重病。需要重症监护病房（ICU）支持治疗的特定抗中性粒细胞胞浆抗体相关性肾血管炎患者的数据有限，主要集中在长期肾脏和总体预后方面。特别是，关于疾病初始阶段重症疾病的数据很少，仍然不确定。因此，本回顾性研究的目的是确定抗中性粒细胞胞浆抗体相关性肾血管炎患者发生重症疾病的预测因素。我们回顾性地纳入了 2015 年至 2020 年间在单中心队列研究中确诊的 53 例抗中性粒细胞胞浆抗体相关性肾血管炎患者。我们发现，抗中性粒细胞胞浆抗体相关性肾血管炎患者的血红蛋白水平低与需要 ICU 支持治疗之间存在关联。此外，入院时血红蛋白水平低于 9.8g/dL 可独立预测抗中性粒细胞胞浆抗体相关性肾血管炎重症患者 ICU 支持治疗的时间延长。这些发现证实了低血红蛋白水平会对短期预后产生负面影响，并进一步加深了我们对贫血在抗中性粒细胞胞浆抗体相关性肾血管炎中的作用的理解。
