End-stage kidney disease due to haemolytic uraemic syndrome - Outcomes in 241 consecutive ANZDATA registry cases

Wen Tang, Janaki Mohandas, Stephen P. McDonald, Carmel M. Hawley, Sunil V. Badve, Neil Boudville, Fiona G. Brown, Philip A. Clayton, Kathryn J. Wiggins, Kym M. Bannister, Scott B. Campbell, David W. Johnson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD) secondary to haemolytic uraemic syndrome (HUS). Methods. The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results: Of the 58422 patients included in the study, 241 (0.4%) had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34) or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12), but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008). 130 (54%) HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%), 5 years (62% vs 85%) and 10 years (49% vs 73%). HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p < 0.001). Sixteen (12%) HUS patients experienced failure of 22 renal allografts due to recurrent HUS. HUS ESKD was not independently associated with the risk of death following renal transplantation (HR 0.92, 95% CI 0.35-2.44, p = 0.87). Conclusions: HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.

LanguageEnglish
Article number164
JournalBMC Nephrology
Volume13
Issue number1
DOIs
Publication statusPublished - 5 Dec 2012
Externally publishedYes

Keywords

  • Chronic
  • Haemolytic uraemic syndrome
  • Kidney Failure
  • Outcomes
  • Renal function recovery
  • Renal transplantation
  • Thrombotic microangiopathy

ASJC Scopus subject areas

  • Nephrology

Cite this

Tang, Wen ; Mohandas, Janaki ; McDonald, Stephen P. ; Hawley, Carmel M. ; Badve, Sunil V. ; Boudville, Neil ; Brown, Fiona G. ; Clayton, Philip A. ; Wiggins, Kathryn J. ; Bannister, Kym M. ; Campbell, Scott B. ; Johnson, David W. / End-stage kidney disease due to haemolytic uraemic syndrome - Outcomes in 241 consecutive ANZDATA registry cases. In: BMC Nephrology. 2012 ; Vol. 13, No. 1.
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title = "End-stage kidney disease due to haemolytic uraemic syndrome - Outcomes in 241 consecutive ANZDATA registry cases",
abstract = "Background: The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD) secondary to haemolytic uraemic syndrome (HUS). Methods. The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results: Of the 58422 patients included in the study, 241 (0.4{\%}) had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95{\%} CI 0.87-1.50, p = 0.34) or dialysis (HR 1.34, 95{\%} CI 0.93-1.93, p = 0.12), but did independently predict recovery of renal function (HR 54.01, 95{\%} CI 1.45-11.1, p = 0.008). 130 (54{\%}) HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73{\%} vs 91{\%}), 5 years (62{\%} vs 85{\%}) and 10 years (49{\%} vs 73{\%}). HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95{\%} CI 1.70-3.95, p < 0.001). Sixteen (12{\%}) HUS patients experienced failure of 22 renal allografts due to recurrent HUS. HUS ESKD was not independently associated with the risk of death following renal transplantation (HR 0.92, 95{\%} CI 0.35-2.44, p = 0.87). Conclusions: HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.",
keywords = "Chronic, Haemolytic uraemic syndrome, Kidney Failure, Outcomes, Renal function recovery, Renal transplantation, Thrombotic microangiopathy",
author = "Wen Tang and Janaki Mohandas and McDonald, {Stephen P.} and Hawley, {Carmel M.} and Badve, {Sunil V.} and Neil Boudville and Brown, {Fiona G.} and Clayton, {Philip A.} and Wiggins, {Kathryn J.} and Bannister, {Kym M.} and Campbell, {Scott B.} and Johnson, {David W.}",
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Tang, W, Mohandas, J, McDonald, SP, Hawley, CM, Badve, SV, Boudville, N, Brown, FG, Clayton, PA, Wiggins, KJ, Bannister, KM, Campbell, SB & Johnson, DW 2012, 'End-stage kidney disease due to haemolytic uraemic syndrome - Outcomes in 241 consecutive ANZDATA registry cases', BMC Nephrology, vol. 13, no. 1, 164. https://doi.org/10.1186/1471-2369-13-164

End-stage kidney disease due to haemolytic uraemic syndrome - Outcomes in 241 consecutive ANZDATA registry cases. / Tang, Wen; Mohandas, Janaki; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil; Brown, Fiona G.; Clayton, Philip A.; Wiggins, Kathryn J.; Bannister, Kym M.; Campbell, Scott B.; Johnson, David W.

In: BMC Nephrology, Vol. 13, No. 1, 164, 05.12.2012.

Research output: Contribution to journalArticle

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T1 - End-stage kidney disease due to haemolytic uraemic syndrome - Outcomes in 241 consecutive ANZDATA registry cases

AU - Tang, Wen

AU - Mohandas, Janaki

AU - McDonald, Stephen P.

AU - Hawley, Carmel M.

AU - Badve, Sunil V.

AU - Boudville, Neil

AU - Brown, Fiona G.

AU - Clayton, Philip A.

AU - Wiggins, Kathryn J.

AU - Bannister, Kym M.

AU - Campbell, Scott B.

AU - Johnson, David W.

PY - 2012/12/5

Y1 - 2012/12/5

N2 - Background: The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD) secondary to haemolytic uraemic syndrome (HUS). Methods. The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results: Of the 58422 patients included in the study, 241 (0.4%) had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34) or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12), but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008). 130 (54%) HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%), 5 years (62% vs 85%) and 10 years (49% vs 73%). HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p < 0.001). Sixteen (12%) HUS patients experienced failure of 22 renal allografts due to recurrent HUS. HUS ESKD was not independently associated with the risk of death following renal transplantation (HR 0.92, 95% CI 0.35-2.44, p = 0.87). Conclusions: HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.

AB - Background: The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD) secondary to haemolytic uraemic syndrome (HUS). Methods. The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results: Of the 58422 patients included in the study, 241 (0.4%) had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34) or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12), but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008). 130 (54%) HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%), 5 years (62% vs 85%) and 10 years (49% vs 73%). HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p < 0.001). Sixteen (12%) HUS patients experienced failure of 22 renal allografts due to recurrent HUS. HUS ESKD was not independently associated with the risk of death following renal transplantation (HR 0.92, 95% CI 0.35-2.44, p = 0.87). Conclusions: HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.

KW - Chronic

KW - Haemolytic uraemic syndrome

KW - Kidney Failure

KW - Outcomes

KW - Renal function recovery

KW - Renal transplantation

KW - Thrombotic microangiopathy

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