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. 2020 Sep 30;9(10):3177.
doi: 10.3390/jcm9103177.

Incidence and Risk Factors of Venous Thromboembolic Events in Patients with ANCA-Glomerulonephritis: A Cohort Study from the Maine-Anjou Registry

Nicolas Henry  1 , Benoit Brilland  1   2 , Samuel Wacrenier  1   3 , Assia Djema  4 , Anne Sophie Garnier  1 , Renaud Gansey  5 , Jean-Philippe Coindre  3 , Virginie Besson  1 , Agnès Duveau  1 , Jean-François Subra  1   2 , Maud Cousin  1 , Giorgina Barbara Piccoli  3 , Jean-François Augusto  1   2
Affiliations

Incidence and Risk Factors of Venous Thromboembolic Events in Patients with ANCA-Glomerulonephritis: A Cohort Study from the Maine-Anjou Registry

Nicolas Henry et al. J Clin Med. .

Abstract

(1) Introduction: The incidence of venous thromboembolisms (VTE) has not been extensively analyzed in patients with antineutrophil cytoplasmic antibody (ANCA)-glomerulonephritis (ANCA-GN). Thus, the aim of the present study was to assess the frequency and the risk factors of VTE in patients with ANCA-GN. (2) Methods: Patients from the Maine-Anjou ANCA-associated vasculitis (AAV) registry with a biopsy showing pauci-immune glomerulonephritis were included. VTE events, site, and interval from AAV diagnosis were analyzed. (3) Results: 133 patients fulfilled the inclusion criteria of the study and were analyzed. VTE episodes were diagnosed in 23/133 (17.3%) patients at a median delay of 3 months from ANCA-GN diagnosis. Patients with VTE had lower serum albumin (p = 0.040), were less frequently on statin therapy (p = 0.009) and had less frequently proteinase-3 (PR3)-ANCAs (p = 0.078). Univariate analysis identified higher age (p = 0.022), lower serum albumin (p = 0.030), lack of statin therapy (p = 0.009), and rituximab treatment (p = 0.018) as significant risk factors of VTE. In multivariate analysis, only lack of statin therapy (HR 4.873; p = 0.042) was significantly associated with VTE. (4) Conclusion: Patients with ANCA-GN are at high risk of VTE, especially within the first months following AAV diagnosis. Our results suggest that statin therapy is associated with a lower risk of VTE in ANCA-GN patients.

Keywords: ANCA glomerulonephritis; risk factor; statins; venous thromboembolism.

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Conflict of interest statement

The authors declare no conflict of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Survival free of thromboembolic events.
Figure 3
Figure 3
Kidney biopsy histology according to early venous thromboembolism (VTE) occurrence. (A) percentage of normal, crescentic, or sclerotic glomeruli in patients with and without early VTE. (B) percentage of patients with VTE according to Berden’s classification. I, focal; II, crescentic; III, mixed; and IV, sclerotic form.
See this image and copyright information in PMC

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