Incidence and outcomes of kidney replacement therapy for end-stage kidney disease due to primary glomerular disease in Europe: findings from the ERA Registry.

dialysis epidemiology kidney replacement therapy kidney transplantation outcome primary glomerular disease

Journal

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
ISSN: 1460-2385
Titre abrégé: Nephrol Dial Transplant
Pays: England
ID NLM: 8706402

Informations de publication

Date de publication:
07 Feb 2024
Historique:
medline: 8 2 2024
pubmed: 8 2 2024
entrez: 8 2 2024
Statut: aheadofprint

Résumé

Primary glomerular disease (PGD) is a major cause of end-stage kidney disease (ESKD) leading to kidney replacement therapy (KRT). We aimed to describe incidence (trends) in individuals starting KRT for ESKD due to PGD and to examine their survival and causes of death. We used data from the European Renal Association (ERA) Registry on 69 854 patients who started KRT for ESKD due to PGD between 2000 and 2019. ERA primary renal disease codes were used to define six PGD subgroups. We examined age and sex standardized incidence, trend of the incidence, and survival. The standardized incidence of KRT for ESKD due to PGD was 16.6 per million population (pmp), ranging from 8.6 pmp in Serbia to 20.0 pmp in France. IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) had the highest incidence of 4.6 pmp and 2.6 pmp, respectively. Histologically non-examined PGDs represented over 50% of cases in Serbia, Bosnia and Herzegovina, and Romania and were also common in Greece, Estonia, Belgium, and Sweden. The incidence declined from 18.6 pmp in 2000 to 14.5 pmp in 2013, after which it stabilized. All PGD subgroups had five-year survival probabilities above 50%, with crescentic glomerulonephritis having the highest risk of death (adjusted hazard ratio: 1.8 [95% confidence interval: 1.6-1.9]) compared with IgAN. Cardiovascular disease was the most common cause of death (33.9%). The incidence of KRT for ESKD due to PGD showed large differences between countries and was highest and increasing for IgAN and FSGS. Lack of kidney biopsy facilities in some countries may have affected accurate assignment of the cause of ESKD. The recognition of the incidence and outcomes of KRT among different PGD subgroups may contribute to a more individualized patient care approach.

Sections du résumé

BACKGROUND AND HYPOTHESIS OBJECTIVE
Primary glomerular disease (PGD) is a major cause of end-stage kidney disease (ESKD) leading to kidney replacement therapy (KRT). We aimed to describe incidence (trends) in individuals starting KRT for ESKD due to PGD and to examine their survival and causes of death.
METHODS METHODS
We used data from the European Renal Association (ERA) Registry on 69 854 patients who started KRT for ESKD due to PGD between 2000 and 2019. ERA primary renal disease codes were used to define six PGD subgroups. We examined age and sex standardized incidence, trend of the incidence, and survival.
RESULTS RESULTS
The standardized incidence of KRT for ESKD due to PGD was 16.6 per million population (pmp), ranging from 8.6 pmp in Serbia to 20.0 pmp in France. IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) had the highest incidence of 4.6 pmp and 2.6 pmp, respectively. Histologically non-examined PGDs represented over 50% of cases in Serbia, Bosnia and Herzegovina, and Romania and were also common in Greece, Estonia, Belgium, and Sweden. The incidence declined from 18.6 pmp in 2000 to 14.5 pmp in 2013, after which it stabilized. All PGD subgroups had five-year survival probabilities above 50%, with crescentic glomerulonephritis having the highest risk of death (adjusted hazard ratio: 1.8 [95% confidence interval: 1.6-1.9]) compared with IgAN. Cardiovascular disease was the most common cause of death (33.9%).
CONCLUSION CONCLUSIONS
The incidence of KRT for ESKD due to PGD showed large differences between countries and was highest and increasing for IgAN and FSGS. Lack of kidney biopsy facilities in some countries may have affected accurate assignment of the cause of ESKD. The recognition of the incidence and outcomes of KRT among different PGD subgroups may contribute to a more individualized patient care approach.

Identifiants

DOI: 10.1093/ndt/gfae034 PMID: 38327216
pubmed: 38327216
pii: 7603382
doi: 10.1093/ndt/gfae034
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.

Auteurs

Samar Abd ElHafeez (SA)

ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
ORCID: 0000-0002-3250-2780

Anneke Kramer (A)

ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands.
ORCID: 0000-0002-7560-2669

Mustafa Arici (M)

Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Miha Arnol (M)

Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.

Anders Åsberg (A)

The Norwegian Renal Registry, Department of Transplantation Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway.

Samira Bell (S)

Scottish Renal Registry, Meridian Court, Glasgow, UK.
Division of Population Health and Genomics, University of Dundee, Dundee, UK.

Julie Belliere (J)

Department of Nephrology and Organ Transplantation, Referral Centre for Rare Kidney Diseases, University Hospital of Toulouse, Toulouse, France.

Carmen Díaz Corte (CD)

Department of Nephrology, Hospital Universitario Central de Asturias, Oviedo University, Oviedo, Spain.

Gema Fernández Fresnedo (GF)

Hospital Universitario Marques de Valdecilla, Servicio de Nefrología, Cantabria, Spain.

Marc Hemmelder (M)

Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
CARIM School for Cardiovascular Diseases, University of Maastricht, Maastricht, The Netherlands.

Line Heylen (L)

Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium.
Dienst Nefrologie, Ziekenhuis Oost-Limburg, Genk, Belgium.
University Hasselt, Hasselt, Belgium.
ORCID: 0000-0002-4595-0195

Kristine Hommel (K)

Nephrology department, Holbaek Hospital, Holbaek, Denmark.

Julia Kerschbaum (J)

Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV - Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria.
ORCID: 0000-0002-6896-2279

Radomir Naumović (R)

Medical School, University of Belgrade, Serbia.

Dorothea Nitsch (D)

London School of Hygiene and Tropical Medicine, London, United Kingdom.
UK Renal Registry, Bristol, UK.

Rafael Santamaria (R)

Andalusian Autonomous Transplant Coordination Information System, Seville, Spain.
Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain.

Patrik Finne (P)

Helsinki University Central Hospital, Division of Nephrology, Helsinki, Finland.

Runolfur Palsson (R)

Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.

Maria Pippias (M)

University of Bristol, Department of Health Care Evaluation, Population Health Sciences, Bristol, UK.
Bright Renal Unit, North Bristol NHS Trust, Bristol, UK.

Halima Resic (H)

Renal Registry of Society of Nephrology, Dialysis and Transplantation of Bosnia and Herzegovina, Clinic for Hemodialysis Sarajevo, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.

Mai Rosenberg (M)

Competence Centre for Rare Diseases, Tartu University Hospital, Tartu, Estonia.

Carmen Santiuste de Pablos (CS)

Murcia Renal Registry, Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

Mårten Segelmark (M)

Division of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Department of Endocrinology, Nephrology and Rheumatology, Skane University Hospital, Lund, Sweden.
ORCID: 0000-0002-1221-0772

Søren Schwartz Sørensen (SS)

Department of Nephrology Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Maria Jose Soler (MJ)

Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain.

Enrico Vidal (E)

Department of Medicine (DAME), University of Udine, Udine, Italy.
Pediatric Nephrology Unit, University-Hospital of Padova, Padova, Italy.

Kitty J Jager (KJ)

ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands.
ORCID: 0000-0003-0444-8569

Alberto Ortiz (A)

Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.
Department of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.
ORCID: 0000-0002-9805-9523

Vianda S Stel (VS)

ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands.

Classifications MeSH