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
机构：[1]Department of Nephrology, Peking University Third Hospital, Beijing, China[2]Division of Nephrology, Princess Alexandra Hospital, Brisbane, Australia,[3]Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia,[4]Australasian Kidney Trials Network, The University of Queensland, Queensland, Australia,[5]Department of Nephrology, Nepean Hospital, Kingswood, Australia,[6]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China,大德路总院肾内科大德路总院肾内科广东省中医院[7]Translational Research Institute, Brisbane, Australia
Background Clinical 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 methods All 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 31 st 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. Results Of 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, p<0.001) and to experience primary kidney disease recurrence in the allograft (aHR 4.92, 95% CI 3.02-8.01, p<0.001). Compared to other forms of glomerulonephritis, MN experienced comparable dialysis and transplant patient survival, but higher rates of kidney transplantation, primary renal disease recurrence and death-censored allograft failure. Conclusion MN 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.
基金：
Australian Organ and Tissue Donation and Transplantation Authority; New Zealand Ministry of Health; Kidney Health Australia; Better Evidence and Translation in Chronic Kidney Disease (BEAT-CKD)
第一作者机构：[1]Department of Nephrology, Peking University Third Hospital, Beijing, China[2]Division of Nephrology, Princess Alexandra Hospital, Brisbane, Australia,[3]Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia,[4]Australasian Kidney Trials Network, The University of Queensland, Queensland, Australia,
共同第一作者：
通讯作者：
通讯机构：[1]Department of Nephrology, Peking University Third Hospital, Beijing, China[2]Division of Nephrology, Princess Alexandra Hospital, Brisbane, Australia,[3]Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia,[4]Australasian Kidney Trials Network, The University of Queensland, Queensland, Australia,
推荐引用方式(GB/T 7714)：
Yang Wen-ling,Bose Bhadran,Zhang Lei,et al.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[J].PLOS ONE.2019,14(8):doi:10.1371/journal.pone.0221531.
APA：
Yang, Wen-ling,Bose, Bhadran,Zhang, Lei,Mcstea, Megan,Cho, Yeoungjee...&Johnson, David W..(2019).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.PLOS ONE,14,(8)
MLA：
Yang, Wen-ling,et al."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".PLOS ONE 14..8(2019)
