Long-term kidney transplant outcomes in primary glomerulonephritis : Analysis from the ERA-EDTA registry
(2016) In Transplantation 100(9). p.1955-1962- Abstract
Background.We evaluated the 15-year kidney allograft survival in patients with primary glomerulonephritis and determined if the risk of graft loss varied with donor source within each glomerulonephritis group. Methods. Using data from the European Renal Association-European Dialysis and Transplant Association Registry, Kaplan-Meier, competing risk, and Cox regression analyses were performed on adult, first kidney transplant recipients during 1991 to 2010 (n = 14 383). Follow-up was set to December 31, 2011. Adjustments for pretransplant dialysis duration, sex, country, and transplant era were made. "Death- Adjusted graft survival" was assessed in patients with glomerulonephritis and compared with thosewith autosomal dominant polycystic... (More)
Background.We evaluated the 15-year kidney allograft survival in patients with primary glomerulonephritis and determined if the risk of graft loss varied with donor source within each glomerulonephritis group. Methods. Using data from the European Renal Association-European Dialysis and Transplant Association Registry, Kaplan-Meier, competing risk, and Cox regression analyses were performed on adult, first kidney transplant recipients during 1991 to 2010 (n = 14 383). Follow-up was set to December 31, 2011. Adjustments for pretransplant dialysis duration, sex, country, and transplant era were made. "Death- Adjusted graft survival" was assessed in patients with glomerulonephritis and compared with thosewith autosomal dominant polycystic kidney disease (ADPKD), in which the native kidney disease cannot recur. Additionally, death- Adjusted graft survival was compared between living and deceased donor transplants within each glomerulonephritis group. Results. All glomerulonephritides had a 15-year death- Adjusted graft survival probability above 55%. The 15-year risk of death- Adjusted graft failure compared to ADPKD ranged from 1.17 (95% confidence interval [95% CI], 1.05-1.31) for immunoglobulin A nephropathy to 2.09 (95% CI, 1.56-2.78) for membranoproliferative glomerulonephritis type II. The expected survival benefits of living over deceased donor transplants were not present in membranoproliferative glomerulonephritis type I (adjusted hazard ratios [HRa], 1.08; 95% CI, 0.73-1.60) or type II (HRa, 0.90; 95% CI, 0.32-2.52) but present in immunoglobulin A nephropathy (HRa, 0.74; 95% CI, 0.59-0.92), membranous nephropathy (HRa, 0.47; 95%CI, 0.29-0.75), and focal segmental glomerulosclerosis (HRa, 0.69; 95%CI, 0.45-1.06). Conclusions.This large European study shows favorable long-term kidney graft survival in all primary glomerulonephritides, although this remains lower than graft survival in ADPKD, and confirms that the reluctance to use living donors in some primary glomerulonephritides remains unfounded. These data will further inform prospective renal transplant recipients and donors during pretransplant counselling.
(Less)
- author
- publishing date
- 2016
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Transplantation
- volume
- 100
- issue
- 9
- pages
- 1955 - 1962
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:84947791497
- pmid:26588008
- ISSN
- 0041-1337
- DOI
- 10.1097/TP.0000000000000962
- language
- English
- LU publication?
- no
- id
- d09d3c48-2f80-4da5-a98e-b7e24c70e10c
- date added to LUP
- 2020-06-23 16:20:34
- date last changed
- 2024-04-17 11:47:27
@article{d09d3c48-2f80-4da5-a98e-b7e24c70e10c,
abstract = {{<p>Background.We evaluated the 15-year kidney allograft survival in patients with primary glomerulonephritis and determined if the risk of graft loss varied with donor source within each glomerulonephritis group. Methods. Using data from the European Renal Association-European Dialysis and Transplant Association Registry, Kaplan-Meier, competing risk, and Cox regression analyses were performed on adult, first kidney transplant recipients during 1991 to 2010 (n = 14 383). Follow-up was set to December 31, 2011. Adjustments for pretransplant dialysis duration, sex, country, and transplant era were made. "Death- Adjusted graft survival" was assessed in patients with glomerulonephritis and compared with thosewith autosomal dominant polycystic kidney disease (ADPKD), in which the native kidney disease cannot recur. Additionally, death- Adjusted graft survival was compared between living and deceased donor transplants within each glomerulonephritis group. Results. All glomerulonephritides had a 15-year death- Adjusted graft survival probability above 55%. The 15-year risk of death- Adjusted graft failure compared to ADPKD ranged from 1.17 (95% confidence interval [95% CI], 1.05-1.31) for immunoglobulin A nephropathy to 2.09 (95% CI, 1.56-2.78) for membranoproliferative glomerulonephritis type II. The expected survival benefits of living over deceased donor transplants were not present in membranoproliferative glomerulonephritis type I (adjusted hazard ratios [HR<sub>a</sub>], 1.08; 95% CI, 0.73-1.60) or type II (HR<sub>a</sub>, 0.90; 95% CI, 0.32-2.52) but present in immunoglobulin A nephropathy (HR<sub>a</sub>, 0.74; 95% CI, 0.59-0.92), membranous nephropathy (HR<sub>a</sub>, 0.47; 95%CI, 0.29-0.75), and focal segmental glomerulosclerosis (HR<sub>a</sub>, 0.69; 95%CI, 0.45-1.06). Conclusions.This large European study shows favorable long-term kidney graft survival in all primary glomerulonephritides, although this remains lower than graft survival in ADPKD, and confirms that the reluctance to use living donors in some primary glomerulonephritides remains unfounded. These data will further inform prospective renal transplant recipients and donors during pretransplant counselling.</p>}},
author = {{Pippias, Maria and Stel, Vianda S. and Aresté-Fosalba, Nuria and Couchoud, Cécile and Fernandez-Fresnedo, Gema and Finne, Patrik and Heaf, James G. and Hoitsma, Andries and De Meester, Johan and Pálsson, Runolfur and Ravani, Pietro and Segelmark, Mårten and Traynor, Jamie P. and Reisæter, Anna V. and Caskey, Fergus J. and Jager, Kitty J.}},
issn = {{0041-1337}},
language = {{eng}},
number = {{9}},
pages = {{1955--1962}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Transplantation}},
title = {{Long-term kidney transplant outcomes in primary glomerulonephritis : Analysis from the ERA-EDTA registry}},
url = {{http://dx.doi.org/10.1097/TP.0000000000000962}},
doi = {{10.1097/TP.0000000000000962}},
volume = {{100}},
year = {{2016}},
}