Long-term outcomes of patients with end-stage kidney disease due to membranous nephropathy: A cohort study using the Australia and New Zealand Dialysis and Transplant Registry

Autor: Wen-ling Yang, David W. Johnson, Bhadran Bose, Elaine M. Pascoe, Megan McStea, Carmel M. Hawley, Magid Fahim, Lei Zhang, Yeoungjee Cho
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Time Factors
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
Kidney
Glomerulonephritis
Membranous
Cohort Studies
Glomerulonephritis
0302 clinical medicine
Recurrence
Chronic Kidney Disease
Medicine and Health Sciences
Renal Transplantation
Membrane Technology
Registries
Kidney transplantation
Multidisciplinary
Graft Survival
Hazard ratio
Middle Aged
Allografts
Separation Processes
Treatment Outcome
Nephrology
Engineering and Technology
Medicine
Female
Anatomy
Research Article
Cohort study
Adult
medicine.medical_specialty
Adolescent
Death Rates
Science
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Urinary System Procedures
Young Adult
03 medical and health sciences
Population Metrics
Membranous nephropathy
Renal Dialysis
Internal medicine
Medical Dialysis
medicine
Humans
Renal replacement therapy
Survival analysis
Dialysis
Aged
Transplantation
Molecular Dialysis
Population Biology
business.industry
Australia
Biology and Life Sciences
Kidneys
Organ Transplantation
Renal System
medicine.disease
Kidney Transplantation
Survival Analysis
Membrane Dialysis
Kidney Failure
Chronic
business
New Zealand
Kidney disease
Zdroj: PLoS ONE, Vol 14, Iss 8, p e0221531 (2019)
PLoS ONE
ISSN: 1932-6203
Popis: BackgroundClinical outcomes of patients with end-stage kidney disease (ESKD) secondary to membranous nephropathy (MN) have not been well described. This study aimed to evaluate patient and/or allograft outcomes of dialysis or kidney transplantation in patients with ESKD secondary to MN.Material and methodsAll adult patients with ESKD commencing renal replacement therapy in Australia and New Zealand from January 1998 to December 2010 were extracted retrospectively from ANZDATA registry on 31st December 2013. Outcomes of MN were compared to other causes of ESKD. In a secondary analysis, outcomes of MN were compared to all patients with ESKD due to other forms of glomerulonephritis.ResultsOf 32,788 included patients, 417 (1.3%) had MN. Compared to other causes of ESKD, MN experienced lower mortality on dialysis (adjusted hazard ratio [aHR] 0.79, 95% CI 0.68-0.92, p = 0.002) and following kidney transplantation (aHR 0.57, 95% CI 0.33-0.97, p = 0.04), had a higher risk of death-censored kidney allograft failure (aHR 1.55, 95% CI: 1.00-2.41, p = 0.05) but comparable risk of overall kidney allograft failure (aHR 1.35, 95% CI 0.91-2.01, p = 0.13). Similar results were obtained using competing-risk regression analyses. MN patients were significantly more likely to receive a kidney transplant (aHR 1.38, 95% CI 1.16-1.63, pConclusionMN was associated with superior survival on dialysis and following kidney transplantation compared to patients with other causes of ESKD, and comparable patient survival compared to patients with other forms of glomerulonephritis. However, patients with MN exhibited a higher rate of death-censored allograft loss as a result of primary kidney disease recurrence.
Databáze: OpenAIRE
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