• M Romeu, C Couchoud, J-C Delarozière, S Burtey, L Chiche, J-R Harlé, B Gondouin, P Brunet, Y Berland, and N Jourde-Chiche.
• From the Department of Nephrology, Hopital Conception, AP-HM, Aix-Marseille Université, 147 Bd Baille, 13385 Marseille Cedex 5, Agence de la Biomédecine, Registre REIN, 1 avenue du Stade de France, 93212 Saint-Denis-La Plaine, France, Department of Public Health, Hopital Timone, AP-HM, Aix-Marseille Université, 27 Bd Jean Moulin, 13385 Marseille Cedex 5 and Department of Internal Medicine, Hopital Conception, AP-HM, Aix-Marseille Université, 147 Bd Baille, 13385 Marseille Cedex 5, France.
• QJM. 2014 Jul 1; 107 (7): 545-55.

BackgroundAnti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) can lead to end-stage renal disease in patients with renal involvement.ObjectiveThis study evaluated the survival of AAV patients on chronic dialysis in France.MethodsBetween 2002 and 2011, a total of 425 AAV patients started chronic dialysis and were registered in the Renal Epidemiology and Information Network. We analysed survival censored for renal transplantation, recovery of renal function and loss to follow-up. AAV patients were compared with 794 matched non-AAV patients on chronic dialysis.ResultsA total of 166 (39%) patients with microscopic polyangiitis and 259 (61%) patients with granulomatosis with polyangiitis were registered. Within a median follow-up of 23 months, 58 (14%) patients received a renal allograft and 19 (4%) recovered renal function. Median survival on dialysis was 5.35 years (95% CI, 4.4-6.3) and survival rates at 3 months, 1, 3 and 5 years were 96%, 85%, 68% and 53%, respectively. A total of 143 (41%) patients died after a median of 16 months. Causes of death were cardiovascular (29%), infections (20%), malnutrition (13%), malignancies (4%), AAV relapse (2%), miscellaneous (14%) and unknown (18%). Multivariate logistic regression identified three independent risk factors associated with AAV patients' mortality: age (HR = 1.05/year, P < 0.001), peripheral artery disease (HR = 2.62, P = 0.003) and frailty (HR = 2.43, P < 0.001). Survival of AAV patients did not differ from non-AAV controls, but infectious mortality was higher in AAV patients (20% vs. 8%, P < 0.001).ConclusionSurvival of AAV patients in chronic dialysis, although poor, was comparable to survival of non-AAV controls on dialysis. There was a similar burden of cardiovascular mortality, but higher infectious mortality.© The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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