GENETIC KIDNEY DISEASE LINKED TO DIFFERENT PATIENT MORTALITY AND GRAFT FAILURE RISKS COMPARED TO OTHER KIDNEY DISEASES ON KIDNEY REPLACEMENT THERAPY
Helen Han1, Venkat Vangaveti2, Matthew Jose3, Andrew John Mallett2,4,5,6, Monica Suet Ying Ng1,4,7 1Kidney Health Service, Royal Brisbane And Women’s Hospital, Brisbane, Queensland, Australia2College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia3Hobart Clinical School, University of Tasmania, Hobart, Tasmania, Australia4Faculty of Medicine, University Of Queensland, Brisbane, Queensland, Australia5Institute of Molecular Biosciences, University Of Queensland, Brisbane, Queensland, Australia6Department of Renal Medicine, Townsville University Hospital, Townsville, Queensland, Australia7Conjoint Internal Medicine Laboratory, Chemical Pathology, Pathology Queensland, Brisbane, Queensland, Australia
Abstract
Aim
This study aimed to profile clinical outcomes in people with genetic kidney disease (GKD) receiving kidney replacement therapy and compare them to those of people with other kidney diseases.
Background
GKDs are among the leading causes of early-onset chronic kidney disease and responsible for >10-15% cases of kidney failure requiring kidney replacement therapy. There is limited population-level information about long term outcomes of people with GKD receiving kidney replacement therapy.
Methods
Data on those who commenced kidney replacement therapy between 1 January, 1989 and 31 December, 2020 were extracted from the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry. GKDs were classified as majority or minority monogenic. People with all other primary kidney diseases were included as the comparator group. Analyses were completed separately for dialysis and transplant cohorts. Outcome measures were mortality (dialysis and transplant cohort) and graft failure (transplant cohort). Unadjusted and adjusted hazard ratios (AHRs) were calculated using Cox proportional hazard regression modelling.
Results
This study included 59,231 dialysis patients and 21,860 transplant recipients. People with majority monogenic (AHR: 0.70, 95% CI 0.66-0.74) and minority monogenic (AHR 0.84, 95% CI 0.79-0.90) GKDs had reduced mortality compared to people with other kidney diseases. After kidney transplantation, people with GKDs had similar mortality risk compared to other kidney diseases. Majority monogenic GKDs were associated with reduced graft failure compared to other kidney diseases (AHR 0.79, 95% CI 0.71-0.87).
Conclusions
This binational registry analysis found that people with GKD had different mortality and graft failure risks compared to people with other kidney diseases. This is the first study to provide a broad longitudinal overview of clinical outcomes in people with GKD.
Biography
Dr Monica Ng is a renal registrar at Royal Brisbane and Women’s Hospital, editorial fellow at Kidney360 and early career clinician scientist. Dr Ng graduated from UQ in 2014 with MBBS with first class honours. She completed her PhD studies in 2019. Dr Ng’s postdoctoral work into developing omics workflows for kidney biomarker discovery and registry analysis for contributors of kidney disease are being completed in conjunction with kidney advanced training. Her long term goals include developing into an independent clinician scientist with research interests in biomarker discovery, kidney immunology and glomerular disease.