Burden of kidney failure from atheroembolic disease and association with survival in people receiving dialysis in Australia and New Zealand: a multi-centre registry study

BMC Nephrology

Arnold Ng¹  Andrea K. Viecelli²  Yeoungjee Cho³  David W. Johnson⁴  Carmel Hawley⁴  Isabelle Ethier⁵  Tahira Scott⁶  Elaine M. Pascoe⁷ 

[1] Department of Cardiology, Princess Alexandra Hospital, Brisbane, Australia;Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, 4102, Brisbane, QLD, Australia;Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia;Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, 4102, Brisbane, QLD, Australia;Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia;Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia;Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, 4102, Brisbane, QLD, Australia;Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia;Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia;Translational Research Institute, Brisbane, Australia;Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, 4102, Brisbane, QLD, Australia;Division of Nephrology, Centre Hospitalier de l’Université de Montréal, Montréal, Canada;Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, 4102, Brisbane, QLD, Australia;School of Medicine, University of Queensland, Brisbane, Australia;School of Medicine, University of Queensland, Brisbane, Australia;Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia;

关键词: Atheroembolic disease;    Dialysis;    Kidney failure;    Outcome;    Registry;    Survival;   

DOI  :  10.1186/s12882-021-02604-7

来源: Springer

【 摘 要 】

BackgroundCardiovascular disease is a leading cause of mortality in kidney failure (KF). Patients with KF from atheroembolic disease are at higher risk of cardiovascular disease than other causes of KF. This study aimed to determine survival on dialysis for patients with KF from atheroembolic disease compared with other causes of KF.MethodsAll adults (≥ 18 years) with KF initiating dialysis as the first kidney replacement therapy between 1 January 1990 and 31 December 2017 according to the Australia and New Zealand Dialysis and Transplant registry were included. Patients were grouped into either: KF from atheroembolic disease and all other causes of KF. Survival outcomes were assessed by the Kaplan-Meier method and Cox regression analysis adjusted for patient-related characteristics.ResultsAmong 65,266 people on dialysis during the study period, 334 (0.5%) patients had KF from atheroembolic disease. A decreasing annual incidence of KF from atheroembolic disease was observed from 2008 onwards. Individuals with KF from atheroembolic disease demonstrated worse survival on dialysis compared to those with other causes of KF (HR 1.80, 95% confidence interval [CI] 1.61–2.03). The respective one- and five-year survival rates were 77 and 23% for KF from atheroembolic disease and 88 and 47% for other causes of KF. After adjustment for patient characteristics, KF from atheroembolic disease was not associated with increased patient mortality (adjusted HR 0.93 95% CI 0.82–1.05).ConclusionsSurvival outcomes on dialysis are worse for individuals with KF from atheroembolic disease compared to those with other causes of KF, probably due to patient demographics and higher comorbidity.

【 授权许可】

CC BY