Predictive factors of mortality in granulomatosis with polyangiitis:A single-center study

Abstract

Objectives: The aim of this study was to identify predictors of mortality in granulomatosis with polyangiitis (GPA) patients and to seek the ways ofimproving survival in GPA patients. Patients and methods: Between January 2005 and June 2020, a total of 60 patients (26 males, 34 females; median age: 49 years; range, 19 to 75years) who were diagnosed with GPA were retrospectively analyzed. Demographic, clinical, laboratory, and radiological findings of all patients wererecorded. Survival rates were analyzed using the Kaplan-Meier plot. Results: The median follow-up was 36 months, and 10 (16.7%) patients died during the study period. Univariate analysis showed that theprognostic values were attributed to high serum creatinine levels (>2.1 mg/dL; p=0.01), proteinuria (p=0.01), dialysis-requiring renal damage atthe time of diagnosis (p=0.01) or at any time during follow-up (p=0.01), low lymphocyte levels (p=0.01), hypoalbuminemia (p=0.04), absence ofupper respiratory tract involvement (p=0.01), presence of lung involvement with cavitary lesions (p=0.01), high Birmingham Vascular Activity Score(p=0.02), and history of serious infection (p=0.01). In the multivariate analysis, the presence of renal damage requiring dialysis at any time duringfollow-up (relative risk [95% confidence interval]: 21 [4.1-18.3]; p=0.01) was found to be an independent predictor of mortality. Immunosuppressivedrugs exerted no effect on mortality, and the most common causes of death were infections (50%). Conclusion: The presence of dialysis-requiring renal damage is the most important risk factor for mortality in GPA patients. These patients shouldbe followed more closely and carefully to improve survival.