The kidney functions of patients were evaluated through Scr levels. Survival data were acquired from digital records of regular follow-up visits, telephone follow-ups, and the dialysis database of Zhejiang Province. Vascular damage index (VDI) at admission is also evaluated ( 12).

All patients were evaluated with the Birmingham Vasculitis Activity Score (BVAS) version 3 according to their status at admission.

And if there were two or more recorded AKI episodes, only the first episode was analyzed. Patients were staged according to the KDIGO clinical practice guidelines for AKI ( 8). Here we retrospectively analyzed AAV patients who reached the KDIGO AKI criteria in our center, trying to describe their characteristics, as well as finding out the associations between AKI stage or short-term kidney function recovery and long-term outcomes.Ĭlinical data including age, gender, blood pressure, smoke, medical history, organs involved, urine output, urine protein, urine red blood cell, the level of C-reactive protein (CRP), myeloperoxidase (MPO)-ANCA or proteinase 3 (PR3)-ANCA, therapies used, and renal biopsy report were retrieved through medical records. There are limited approaches to evaluate the level of progression of renal injuries caused by AAV. The criteria and staging system proposed by the Kidney Disease: Improving Global Outcome (KDIGO) group based on the time and level of increase of creatinine or decrease of urine output is recommended for evaluating the severity of AKI and predicting renal outcomes ( 6, 7). Studies have shown that AKI is a risk factor for ESRD, and is associated with poor survival outcomes ( 5). In some patients, the clinical course of kidney injury can be very aggressive and can reach the criteria of acute kidney injury (AKI).ĪKI is characterized as sudden renal impairment. It can present with a rapid decline of kidney function and may need renal replacement therapy within a few days, and even lead to end-stage renal disease (ESRD). A typical manifestation of renal involvement is aggressive kidney vasculitis ( 4). It occurs in about 90% of patients with microscopic polyangiitis (MPA), and about 70% of patients with granulomatosis with polyangiitis (GPA) ( 3). Kidney involvement is common in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) ( 1, 2).

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