Objectives: Antineutrophil cytoplasmic autoantibody (ANCA) associated small vessel vasculitis (AASV) constitutes a group of life-threatening diseases and renal involvement is its most severe and common manifestation. Acute kidney injury (AKI) is common in patients with AASV but the value of RIFLE criteria is still unclear in those patients.
Methods: We performed a retrospective study on patients with AASV in Shanghai Ruijin Hospital from 1997 to 2008.
Results: A total of 147 ANCA-associated renal vasculitis patients were studied and 92 developed AKI at diagnosis. According to RIFLE classification, 8 (8/147, 5.44%) patients had AKI-R, 15 (15/147, 10.20%) had AKI-I and 69 (69/147, 46.94%) had AKI-F. Our results demonstrated that more hypertensive patients and higher BVAS were found in patients with AKI-F than those in other groups (p<0.01 and p<0.01, respectively). Survival rate was significantly lower among patients with advanced RIFLE categories during remission-induction therapy (p<0.05). Survival rate of 1 year and total survival rate were significantly lower among patients with advanced RIFLE categories (p<0.01, p=0.001, respectively). Cox regression analysis demonstrated that advanced RIFLE categories were associated with a worse prognosis of the patients (OR=1.706, 95%CI: 1.262-2.307, p<0.01). The area under the ROC curve for mortality was 0.718 (95% CI: 0.63-0.81, p<0.001).
Conclusions: The RILFE criteria is a valid measurement of both prognosis and progression in patients with AASV.