Nephrology Dialysis Transplantation, Vol 13, Issue 7 1713-1718, Copyright © 1998 by Oxford University Press
M Haubitz, K Koch and R Brunkhorst
Background: In patients with end-stage renal disease
(ESRD) due to Wegener's granulomatosis, a decrease in vasculitis activity
after the development of ESRD, as described in other autoimmune diseases,
has been postulated. However, up to now no data in a larger group of
patients with Wegener's granulomatosis on chronic dialysis have been
available. Methods: We retrospectively analysed the
clinical course of 35 patients with Wegener's granulomatosis and ESRD
during chronic dialysis treatment. Diagnosis was based on clinical
manifestation, antineutrrophil cytoplasmic antibodies and/or histology.
Results: During a mean follow-up of 43 months (5-113
months), six patients died, three related to treatment toxicity. The
patient survival rates (according to Kaplan-Meier calculation) were 93%
after 2 years and 79% after 5 years. Twenty-nine relapses of Wegener's
granulomatosis occurred in 17 patients (relapse rate 0.24/patient/year);
2/3 of the relapses were seen during treatment with steroids, 1/6 during
cyclophosphamide therapy. The relapses were not related to the dialysis
membrane used. Remission or partial remission could be achieved in 93% of
the relapses. Conclusions: The survival of patients on
chronic dialysis treatment due to Wegener's granulomatosis was comparable
to that of other patient groups with ESRD. The relapse rate was not
different from that of non-dialysed patients with Wegener's granulomatosis,
and this finding underlines the need for a therapeutic strategy to maintain
long-term remission in dialysis-dependent patients, too. Key
words: chronic dialysis; end-stage renal disease; relapse;
vasculitis; Wegener's granulomatosis
ORIGINAL ARTICLES
Survival and vasculitis activity in patients with end-stage renal disease due to Wegener's granulomatosis
Department of Nephrology, Medizinische Hochschule, D-30623 Hannover, Germany; Corresponding author
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