Clinical and experimental nephrology · 2026
Impact of frailty on prognosis in elderly patients with organ-threatening ANCA-associated vasculitis.
СтатьяНазвание и аннотация: Перевод в очереди
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Taito Kenta, Hashimoto Seiji, Fukushima Kaoruko, Ogawa Keitaro, Yatabe Kanako, Izawa Ayano, Ohta Yui, Matsuno Shiho, Oka Masatoshi, Suzuki Noriyuki, Takei Takashi, Itabashi Mitsuyo
Аннотация
BACKGROUND: Frailty has gained attention as an important prognostic factor in autoimmune diseases, but its clinical impact in organ-threatening ANCA-associated vasculitis (AAV) remains poorly understood. While recent advances in treatment have improved survival outcomes in AAV, maintaining quality of life (QOL) remains a challenge. This study investigated the impact of frailty on prognosis in elderly patients with severe AAV.
METHODS: We retrospectively analyzed 23 newly diagnosed AAV patients with renal involvement. Frailty was assessed using the Clinical Frailty Scale (CFS). Patients were divided into robust and frail groups based on pre-AAV onset CFS scores. We compared clinical characteristics, treatment, outcomes, and CFS progression between groups. We also investigated predictors of serious adverse events (SAEs).
RESULTS: No significant difference in age was observed between the robust and frail groups. The frequency of rituximab, intravenous cyclophosphamide, and avacopan use was comparable between groups. Two deaths occurred during the 6-month follow-up period, both in the frail group. Serious adverse events (SAEs) occurred significantly more frequently in frail patients (66.7% vs. 9.1%, p < 0.01). Survival time analysis demonstrated a markedly higher SAE risk in the frail group (log-rank: p < 0.01, HR: 6.07). Patients who developed SAEs experienced progressive deterioration of frailty, whereas those who did not developed stable or improved frailty.
CONCLUSION: In organ‑threatening AAV, frailty may be associated with an increased risk of severe adverse events and functional decline. These exploratory findings suggest a potential role for frailty assessment in initial risk stratification.
METHODS: We retrospectively analyzed 23 newly diagnosed AAV patients with renal involvement. Frailty was assessed using the Clinical Frailty Scale (CFS). Patients were divided into robust and frail groups based on pre-AAV onset CFS scores. We compared clinical characteristics, treatment, outcomes, and CFS progression between groups. We also investigated predictors of serious adverse events (SAEs).
RESULTS: No significant difference in age was observed between the robust and frail groups. The frequency of rituximab, intravenous cyclophosphamide, and avacopan use was comparable between groups. Two deaths occurred during the 6-month follow-up period, both in the frail group. Serious adverse events (SAEs) occurred significantly more frequently in frail patients (66.7% vs. 9.1%, p < 0.01). Survival time analysis demonstrated a markedly higher SAE risk in the frail group (log-rank: p < 0.01, HR: 6.07). Patients who developed SAEs experienced progressive deterioration of frailty, whereas those who did not developed stable or improved frailty.
CONCLUSION: In organ‑threatening AAV, frailty may be associated with an increased risk of severe adverse events and functional decline. These exploratory findings suggest a potential role for frailty assessment in initial risk stratification.