End-stage renal failure due to amyloidosis: Outcomes in 490 ANZDATA registry cases

Wen Tang, Stephen P. McDonald, Carmel M. Hawley, Sunil V. Badve, Neil Boudville, Fiona G. Brown, Philip A. Clayton, Scott B. Campbell, Janak R. De Zoysa, David W. Johnson

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background There are few reports regarding the long-term renal replacement therapy (RRT) outcomes of amyloidosis.MethodsIn this retrospective, multi-centre, multi-country registry analysis, all patients with and without amyloidosis who commenced RRT for end-stage renal failure (ESRF) in Australia and New Zealand between 1963 and 2010 were included.ResultsOf 58 422 patients who underwent RRT during the study period, 490 (0.8%) had ESRF secondary to amyloidosis. The median survival of amyloidosis patients on dialysis (2.09 years, 95% CI 1.85-2.32 years) was significantly inferior to that of patients with other causes of ESRF (4.45 years, 95% CI 4.39-4.51 years) (log-rank score 242, P < 0.001). The survival of amyloidosis patients receiving peritoneal dialysis (1.9 years, 95% CI 1.58-2.22) was comparable with those receiving haemodialysis (2.17 years, 95% CI 1.89-2.45) (P = 0.18). Fifty-three (13.8%) amyloidosis patients died of amyloidosis complications. Forty-six patients underwent renal transplantation with first graft survival rates of 45% at 5 years and 26% at 10 years. Nine (16.4%) patients experienced amyloidosis recurrence in their allografts, which led to graft failure in six patients. ESRF patients with amyloidosis experienced inferior median first renal allograft survival (4.55 years, 95% CI 1.96-7.15 versus 10.7 years, 95% CI 10.5-11.0, P = 0.001) and transplant patient survival (6.03 years, 95% CI 2.71-9.36 versus 16.8 years, 95% CI 16.4-17.1, P < 0.001) compared with patients with other causes of ESRF. Respective 10-year patient survival rates were 37 and 69%.ConclusionsAmyloidosis was associated with poor patient survival following dialysis and/or renal transplantation, poor renal allograft survival and a significant incidence of disease recurrence in the allograft. An appreciable proportion of amyloid ESRF patients died of amyloidosis-related complications.

LanguageEnglish
Pages455-461
Number of pages7
JournalNephrology Dialysis Transplantation
Volume28
Issue number2
DOIs
Publication statusPublished - 1 Feb 2013
Externally publishedYes

Keywords

  • amyloidosis
  • end-stage renal failure
  • outcomes
  • recurrence
  • renal transplantation

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Tang, W., McDonald, S. P., Hawley, C. M., Badve, S. V., Boudville, N., Brown, F. G., ... Johnson, D. W. (2013). End-stage renal failure due to amyloidosis: Outcomes in 490 ANZDATA registry cases. Nephrology Dialysis Transplantation, 28(2), 455-461. https://doi.org/10.1093/ndt/gfs492