ANCA comes of age-but with caveats

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis are predominantly diseases of older patients, frequently involving the kidney. Bomback and colleagues studied disease outcome in very elderly patients (> 80 years old) with ANCA-associated renal disease. Immunosuppression resulted in lower rates of end-stage renal disease at 1 year and lower mortality at 2 years. Although these data suggest we should treat these elderly patients with immunosuppression, the criteria for patient selection and the dosage and duration of the treatment regimen need to be established. Kidney International (2011) 79, 699-701. doi: 10.1038/ki.2010.558