CHARACTERISTICS AND CLINICAL OUTCOMES OF PEOPLE WITH KIDNEY FAILURE OF UNKNOWN AETIOLOGY FROM ANZDATA REGISTRY
LUCY SHU WANG1, VENKAT N VANGAVETI2,3, 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, Australia3Townsville Institute of Health Research and Innovation, Townsville University Hospital, Douglas, Queensland, Australia4Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia5Department of Renal Medicine, Townsville University Hospital, Douglas, Queensland, Australia6Institute of Molecular Biosciences, University Of Queensland, Brisbane, Queensland, Australia7Conjoint Internal Medicine Laboratory, Chemical Pathology, Pathology Queensland, Brisbane, Queensland, Australia
Abstract
Aim: To assess clinical outcomes of people on kidney replacement therapy with kidney failure of unknown aetiology (uESKD).
Background: There is limited information about the characteristics of people with uESKD; as well as their clinical outcomes after onset of kidney failure, including mortality risk.
Methods: Using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry, we included people who commenced kidney replacement therapy from 1989-2021. Primary exposure was cause of kidney failure – uESKD or other. Primary outcome was mortality. Dialysis and transplant cohorts were analysed separately. Cox Proportional Hazards Regression models were used to evaluate correlations between cause of kidney failure and mortality risk. Subgroup analyses were completed to compare mortality risk in people with uESKD to those with diabetic nephropathy, autosomal dominant polycystic kidney disease (ADPKD), glomerular disease and other kidney diseases.
Results: This study included 60,448 people on dialysis and 20,859 transplant recipients. 1-year, 3-year and 5-year mortality rates in people with uESKD on dialysis were 31.6%, 58.7% and 77.2%, respectively. 1-year, 3-year and 5-year mortality rates in transplant recipients with uESKD were 2.8%, 13.8% and 24.0%, respectively. People with uESKD on dialysis had a higher mortality risk compared to those without uESKD on univariable and multivariable analyses (adjusted hazard ratio [AHR] 1.10, 95% CI 1.06-1.16, p<0.001). Transplant recipients with uESKD have a higher mortality risk compared to those without uESKD on univariable and multivariable analyses (AHR 1.17, 95% CI 1.01-1.35, p<0.05).
Conclusions: People with uESKD on kidney replacement therapy have higher mortality risk compared to people with other kidney diseases. Further studies are required to identify contributing factors to these findings.