Vasculitic renal disease*

The kidney may be involved in several forms of systemic vasculitis, particularly those affecting small-calibre blood vessels. Hence, the majority of cases involve patients with Wegener's granulomatosis, Churg-Strauss syndrome or microscopic polyangiitis. Anti-neutrophil cytoplasmic antibodies (ANCA) are found in the majority of these patients and their detection has increased the sensitivity and specificity of diagnosis. However, the role of ANCA in the pathogenesis of these lesions remains uncertain. Moreover, the approach to treatment, both in terms of induction and maintenance of remission, remains problematic. This brief review discusses aspects of ANCA and current approaches to management.