The KDIGO 2024 Clinical Practice Guideline for Antineutrophilic Cytoplasmic Antibody (ANCA)-associated Vasculitis is a focused update of the ANCA Vasculitis chapter of the KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. The guideline was published in the March 2024 issue of Supplements to Kidney International, with an Executive Summary in the main pages of the journal. The guideline was co-chaired by Brad Rovin, MD (United States) and Jürgen Floege, MD (Germany), who co-chaired the 2021 Glomerular Diseases Guideline and will co-chair future chapter updates.
The guideline provides updated recommendations and practice points based on evidence from randomized controlled trials published since July 2022. This includes new evidence on using lower doses of corticosteroids like rituximab and complement inhibition to treat ANCA vasculitis, as well as the use of avacopan as an alternative to glucocorticoids. The guideline also addresses therapies like plasma exchange for use in patients with advanced kidney disease.
Development of the guideline update followed an explicit process of evidence review and appraisal. Treatment approaches and guideline recommendations are based on systematic reviews of relevant studies. Appraisal of the certainty of the evidence and the strength of recommendations followed the “Grading of Recommendations Assessment, Development and Evaluation” (GRADE) approach. Limitations of the evidence are discussed, and areas of future research are also presented.
DISCLAIMER: USE OF THE CLINICAL PRACTICE GUIDELINES
This Clinical Practice Guideline is based upon the best information available at the time of publication. The recommendations are designed to provide information and assist decision-making. They are not intended to define a standard of care, and should not be construed as one. Neither should they be interpreted as prescribing an exclusive course of management. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every health care professional making use of this Guideline is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. The recommendations for research contained within this document are general and do not imply a specific protocol.
