ANCA-vasculitis

What is ANCA vasculitis?

Vasculitis refers to inflammation of the blood vessels. Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis is an autoimmune disease where the body attacks itself by making antibodies (produced by our immune system, generally to protect us against infection) but in this case, that attack white blood cells and damage blood vessels (causing the vasculitis).

How does ANCA vasculitis damage the kidneys?

Different organs can be affected by ANCA vasculitis, including the skin, lungs and kidneys.

The kidneys have lots of small blood vessels that can be affected so most people with ANCA vasculitis often have problems with their kidneys which can lead to poorer kidney function or even kidney failure.

ANCA vasculitis symptoms

Symptoms depend on the type of vasculitis and the affected organ, but general symptoms of most types can include:

Fever

Headache

Fatigue

Weight loss

General aches and pains

Skin rash

Sinus, ear or nose symptoms

When the kidneys are affected, occasionally blood may be seen in the urine or the amount of urine passed may suddenly reduce or stop.

ANCA vasculitis diagnosis

There is no single test for vasculitis, and it may vary depending on the type of disease. The patient may be examined in the following ways:

Blood tests may be performed to show damage to the kidneys or may show the presence of ANCA antibodies.

X-rays or other imaging techniques may be used to check for signs of vasculitis that particularly affect the lungs.

Biopsies may be taken from the kidneys to confirm any damage to the blood vessels by looking at patterns of inflammation caused by ANCA vasculitis.

Urine tests will show any blood or protein in the urine, which can indicate ANCA vasculitis or other inflammatory diseases. The amount of protein in the urine can be calculated as the albumin: creatinine ratio (ACR).

ANCA vasculitis treatment

Treatment can involve steroids (prednisolone), or a new drug called avacopan, which are medications designed to reduce inflammation in the body.

Avacopan was authorised for use in the UK in 2022 for ANCA vasculitis and may be considered as part of a care plan by a healthcare professional. These will be taken with other medications, called immunosuppressants, which work to prevent the immune system from attacking its own tissues and cells. These may be tablets but often are infusions, given every few weeks or months. This approach is often used to manage autoimmune conditions where it is essential to reduce damage to organs and systems affected by the disease.

In some cases, a treatment called ‘plasma exchange’ may also be used to remove ANCA antibodies from the blood plasma (the part of blood that carries antibodies).

Lastly, if patients with renal vasculitis develop kidney failure, then they may require dialysis or a kidney transplantation.

Speak with your doctor or specialist team for advice on treatment options.

Resources for ANCA vasculitis

Don’t hesitate to speak to your GP or kidney specialist if you have any questions or concerns. For more information visit:

ANCA Associated Vasculitis and the Kidney - Vasculitis UK

Vasculitis - NHS (www.nhs.uk)

Reviewed September 2025

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Research spotlight

Patients with ANCA associated vasculitis are more likely to form excessive blood clots.

Dr Tom McKinnon, and his team at Imperial College London, are investigating why this is by replicating blood flow through blood vessels to look at the effect of the ANCA antibodies.

This research could uncover ways to prevent or treat the harmful clots.

Read about the research