Vasculitis & polymyalgia rheumatica
Renal outcomes in ANCA-associated vasculitis without clinically apparent kidney involvement: a multicentre REVEAL cohort study
Authors' conclusion
In AAV without clinically apparent kidney involvement, TWA-CRP, as a surrogate of sustained systemic inflammation, was associated with incident CKD.
Study context
- Population
- Patients with ANCA-associated vasculitis (AAV), multicentre REVEAL cohort
- Participants
- 129 vs 228
- Exposure
- Kidney Birmingham Vasculitis Activity Score (BVAS) = 0 vs kidney BVAS ≥1
- Kidney BVAS = 0n = 129
- Kidney BVAS ≥ 1n = 228reference
- Outcome
- Incident CKD in the kidney BVAS = 0 group: at least two eGFR values <60 ml/min/1.73 m² at least 90 days apart, with decline ≥30% from baseline
- Follow-up
- 3 years
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Incident CKD, kidney BVAS = 0
Kidney BVAS = 0
30.7%
30
Observational data: associations, not effects.
Further findings
Estimated glomerular filtration rate (eGFR) trajectory after remission induction
- eGFR improved in kidney BVAS ≥ 1 but declined in kidney BVAS = 0, regardless of treatment intensity
Baseline-to-1-month time-weighted average CRP (TWA-CRP) and incident chronic kidney disease (CKD) (kidney BVAS = 0)
- Age-adjusted HR
- 1.21; 95% CI 1.06-1.39; P < 0.01
- Older age also associated with incident CKD in Cox models
TWA-CRP from 1 to 6 months ≥0.5 mg/dl at 6-month landmark and incident CKD
- HR
- 2.61; 95% CI 1.01-6.78; P = 0.049
Original publication
Renal outcomes in ANCA-associated vasculitis without clinically apparent kidney involvement: a multicentre REVEAL cohort study. Rheumatology (Oxford). Published 9 March 2026. doi:10.
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