Prudence Gregory1, M Hasib Sidiqi2,3, Chris Davies4,5, Ashley Irish2
1Sir Charles Gairdner Hospital, Nedlands, Australia, 2Fiona Stanley Hospital, Murdoch, Australia, 3Curtin Medical School, Curtin University, Perth , Australia, 4Australia & New Zealand Dialysis & Transplant Registry, South Australian Health & Medical Research Institute, Adelaide, Australia, 5Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, Australia
Biography:
Prudence is a third year nephrology advanced trainee who is currently based at Sir Charles Gairdner Hospital in Perth. She has keen interest in glomerular disease and transplantation.
Aim:
To review the incidence and outcomes of End Stage Kidney Disease (ESKD) secondary to amyloidosis in Australia and New Zealand.
To compare the use of dialysis and transplantation for the management of ESKD secondary to amyloidosis by era.
Background:
Amyloidosis is a rare cause of ESKD requiring renal replacement therapy (RRT). Previous ANZDATA registry analysis (2013) reported poor median overall survival for patients with ESKD secondary to amyloidosis. Since that time, there has been substantial advancements in amyloidosis management which may have resulted in improved survival.
Methods:
Retrospective registry analysis of all adults with ESKD requiring RRT and/or renal transplantation in Australia and New Zealand from 1963 to 2023.
Results:
In total, 802/103,231 patients required RRT in Australia and New Zealand secondary to amyloidosis and 84/802 amyloidosis patients (10.5%) received a renal transplant. The median age (years) at commencement of RRT was 59 non-amyloid and 65 amyloid (p <0.001). Females accounted for 39.9 % non-amyloid and 40 % amyloid. Diabetes was present in 45.2 % non-amyloid and 11.7 % amyloid (p < 0.001). The median survival for ESKD secondary to amyloidosis on RRT has improved from 2.13 years (1963–2010) to 3.44 years (2011–2023), compared with non-amyloid 5.8 to 6.3 years. Patient median survival (years) after transplant was 6.0 amyloid and 16.7 non-amyloid in 1963–2010 (p <.0001). Survival in the 2011–2023 cohort does not differ (p = 0.31) and median survival is not reached with 32/37 (86 %) amyloid and 8990/10121 (89%) non-amyloid alive at the end of follow up.
Conclusions:
The survival of patients with amyloidosis and ESKD especially those receiving renal transplantation has significantly improved since 2010 suggesting improved therapy and patient management.
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