{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:38:51Z","timestamp":1791545931911,"version":"4.3.4"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2021,9]]},"abstract":"\n Significance Statement<\/jats:title>\n The clinical significance of arteritis of the small kidney arteries has not been evaluated in detail in antineutrophil cytoplasmic antibody\u2013associated vasculitis (AAV). A large multicenter cohort of 251 patients diagnosed with AAV and renal involvement, including 34 (13.5%) patients with arteritis, found patients with arteritis were older and had a more severe inflammatory syndrome compared with patients who did not have arteritis. The presence of arteritis on kidney biopsy was associated with poorer renal prognosis, independent of current risk stratification predictive models. The addition of the arteritis status significantly improved risk stratification of ESKD in patients classified as having low or moderate risk according to the ANCA renal risk score. The incidence and phenotype of this AAV subtype were confirmed in two external validation cohorts.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Renal involvement in ANCA\u2013associated vasculitis (AAV) is associated with poor outcomes. The clinical significance of arteritis of the small kidney arteries has not been evaluated in detail.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In a multicenter cohort of patients with AAV and renal involvement, we sought to describe the clinicopathologic characteristics of patients with AAV who had renal arteritis at diagnosis, and to retrospectively analyze their prognostic value.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We included 251 patients diagnosed with AAV and renal involvement between 2000 and 2019, including 34 patients (13.5%) with arteritis. Patients with AAV-associated arteritis were older, and had a more pronounced inflammatory syndrome compared with patients without arteritis; they also had significantly lower renal survival (\n P<\/jats:italic>\n =0.01). In multivariable analysis, the ANCA renal risk score, age at diagnosis, history of diabetes mellitus, and arteritis on index kidney biopsy were independently associated with ESKD. The addition of the arteritis status significantly improved the discrimination of the ANCA renal risk score, with a concordance index (C-index) of 0.77 for the ANCA renal risk score alone, versus a C-index of 0.80 for the ANCA renal risk score plus arteritis status (\n P<\/jats:italic>\n =0.008); ESKD-free survival was significantly worse for patients with an arteritis involving small arteries who were classified as having low or moderate risk, according to the ANCA renal risk score. In two external validation cohorts, we confirmed the incidence and phenotype of this AAV subtype.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our findings suggest AAV with renal arteritis represents a different subtype of AAV with specific clinical and histologic characteristics. The prognostic contribution of the arteritis status remains to be prospectively confirmed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.2020071074","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T14:30:23Z","timestamp":1624285823000},"page":"2362-2374","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":41,"title":["Reappraisal of Renal Arteritis in ANCA-associated Vasculitis: Clinical Characteristics, Pathology, and Outcome"],"prefix":"10.1681","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8045-1658","authenticated-orcid":false,"given":"Idris","family":"Boudhabhay","sequence":"first","affiliation":[{"name":"Department of Pathology, Necker Hospital, Paris, France"},{"name":"Department of Nephrology and Transplantation, Necker Hospital, Paris, France"},{"name":"Paris University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Delestre","sequence":"additional","affiliation":[{"name":"Paris University, Paris, France"},{"name":"Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Coutance","sequence":"additional","affiliation":[{"name":"Paris-Sorbonne University, Paris, France"},{"name":"Department of Cardiac and Thoracic Surgery, Cardiology Institute, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane","family":"Gnemmi","sequence":"additional","affiliation":[{"name":"Pathology Department, Lille University Hospital, Lille, France"},{"name":"JPARC-Jean-Pierre Aubert Research Center, Lille, 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University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Tricot","sequence":"additional","affiliation":[{"name":"Department of Nephrology, H\u00f4pital Foch, Suresnes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Gosset","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Centre Universitaire de la R\u00e9union, La R\u00e9union, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Hummel","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, Necker Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Terrier","sequence":"additional","affiliation":[{"name":"Paris University, Paris, France"},{"name":"Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Paris, 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