Journal of Clinical & Experimental Nephrology

Anca Vasculitis

Webinar on Global Summit on Nephrology, Urology and Kidney Transplantation
January 21, 2022 | Webinar

Kresimir Galesic

University of Zagreb, Zagreb, Croatia

ScientificTracks Abstracts: J Clin Exp Nephrol

Abstract

Antineutrophil cytoplasmatic autoantibodies (ANCA) are associated with a group of necrotizing small vessel vasculitis that have a paucity of vascular deposition of immunoglobulin and complement. Two major autoantigens for ANCA are myeloperoxidase (MPO) and proteinase 3 (PR3), which are proteins in the primary granules of neutrophils. According to Chapel Hill classification, the group of systemic small vessel vasculitis associated with ANCA include microscopic polyangiitis (MPA), Wegener’s granulomatosis (WG), and Churg–Strauss syndrome. Pathogenesis of ANCA-associated vasculitis ANCA directed to proteinase 3 (PR3-ANCA) or myeloperoxidase (MPO-ANCA) are strongly associated with the small blood vessels. The kidney is the most affected organ in ANCA-associated vasculitis, and patient outcomes are largely determined by the severity of renal disease at diagnosis and by its response to treatment. The manifestations of ANCA disease can be limited to the kidney alone, or may involve upper respiratory tract, the lungs, the skin, or several other organs in various combinations The treatment of renal vasculitis involves the use of high dose glucocorticoids in combination with cyclophosphamide to induce remission of disease. The duration of this induction therapy is 3-6 months. In the presence of kidney failure, plasma exchange (plasmapheresis) is often used in addition to pharmacological treatment. Once remission is achieved, treatment is scaled back to maintenance therapy with lower doses of glucocorticoids, while cyclophosphamide is replaced by a less toxic immunosuppressant, such as azathioprine.

Biography

Krešimir Galešić, (MD, PhD) completed his medical education at University of Zagreb, School of Medicine in 1981. He finished his residency in Internal Medicine in 1990 and in Nephrology 1993. He was trained at Tufts University, Boston, USA (1993 – 1995) and by Professor Claudio Ponticelli at Ospedale Magiore, Milan, Italy. He is the Head of Department of Nephrology, Dubrava University Hospital Zagreb and the full professor of Internal Medicine at University of Zagreb, School of Medicine.