TY - JOUR
T1 - End-stage renal failure due to amyloidosis
T2 - Outcomes in 490 ANZDATA registry cases
AU - Tang, Wen
AU - McDonald, Stephen P.
AU - Hawley, Carmel M.
AU - Badve, Sunil V.
AU - Boudville, Neil
AU - Brown, Fiona G.
AU - Clayton, Philip A.
AU - Campbell, Scott B.
AU - De Zoysa, Janak R.
AU - Johnson, David W.
N1 - Funding Information:
Pty Ltd and has previously received research funds from the company. He has also received speakers’ honoraria and research grants from Fresenius Medical Care and is a current recipient of a Queensland Government Health Research Fellowship. F.B. is a consultant for Baxter and Fresenius and has received travel grants from Amgen and Roche. S. M. has received speaking honoraria from AMGEN Australia, Fresenius Australia and Solvay Pharmaceuticals and travel grants from AMGEN Australia, Genzyme Australia and Jansen-Cilag. C.H. has received research funds from Amgen, Roche, Shire and Abbott, travel grants from Amgen, speaking honoraria from Amgen, Roche, Shire, Genzyme and Fresenius. N.B. has previously received research funds from Roche, travel grants from Roche, Amgen and Jansen Cilag, and speaking honoraria from Roche. The remaining authors have no competing financial interests to declare. The results presented in this paper have not been published previously in whole or part, except in abstract format.
Funding Information:
Acknowledgements. The authors gratefully acknowledge the substantial contributions of the entire Australian and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators and patients) in providing information for and maintaining the ANZDATA Registry database. W.T. was supported by grants from National Natural Science Foundation of China (Project 30900681), Beijing Municipal Science & Technology Commission (D09050704310905) and Fund of Peking University Third Hospital (76496-02).
PY - 2013/2
Y1 - 2013/2
N2 - 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.
AB - 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.
KW - amyloidosis
KW - end-stage renal failure
KW - outcomes
KW - recurrence
KW - renal transplantation
UR - http://www.scopus.com/inward/record.url?scp=84874514513&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfs492
DO - 10.1093/ndt/gfs492
M3 - Article
C2 - 23182810
AN - SCOPUS:84874514513
VL - 28
SP - 455
EP - 461
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
IS - 2
ER -