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    Long-term outcomes of kidney transplant recipients with end-stage kidney disease attributed to presumed/advanced glomerulonephritis or unknown cause.

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    Author
    Lim, WH; Wong, G; McDonald, SP; Chakera, A; Luxton, G; Isbel, NM; Pilmore, HL; Barbour, T; Hughes, P; Chadban, SJ
    Date
    2018-06-13
    Source Title
    Scientific Reports
    Publisher
    Springer Science and Business Media LLC
    University of Melbourne Author/s
    Barbour, Thomas; Hughes, Peter
    Affiliation
    Medicine and Radiology
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Lim, W. H., Wong, G., McDonald, S. P., Chakera, A., Luxton, G., Isbel, N. M., Pilmore, H. L., Barbour, T., Hughes, P. & Chadban, S. J. (2018). Long-term outcomes of kidney transplant recipients with end-stage kidney disease attributed to presumed/advanced glomerulonephritis or unknown cause.. Sci Rep, 8 (1), pp.9021-. https://doi.org/10.1038/s41598-018-27151-4.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255333
    DOI
    10.1038/s41598-018-27151-4
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5998026
    Abstract
    People with biopsy-proven glomerulonephritis (GN) as their cause of end-stage kidney disease (ESKD) who undergo kidney transplantation incur significant risk of recurrent GN-related graft failure, but the risk in recipients with ESKD where GN was suspected but not biopsy proven (presumed/advanced GN) and when the cause of ESKD is unknown remains uncertain. Using the Australia and New Zealand Dialysis and Transplant registry, we examined the associations between primary kidney transplant recipients whose ESKD was attributed to: 1) commonly-recurring GN (i.e. IgA nephropathy, membranoproliferative GN, focal segmental glomerulosclerosis and membranous GN), 2) presumed/advanced GN, and 3) cause of ESKD unknown (uESKD) and GN-related graft failure using adjusted competing risk models. Of 5258 recipients followed for a median of 8 years, 3539 (67.3%) had commonly-recurring GN, 1195 (22.7%) presumed/advanced GN, and 524 (10.0%) uESKD. Compared to recipients with commonly-recurring GN, recipients with presumed/advanced GN or uESKD experienced a low incidence of GN-related graft failure (<1%) and a lower hazard of GN-related graft failure (adjusted sub-distribution hazard ratio [HR] 0.28 [95%CI 0.15-0.54,p < 0.001] and 0.20 [95%CI 0.06-0.64,p = 0.007], respectively). People with ESKD attributed to either presumed/advanced GN or unknown cause face a very low risk of graft failure secondary to GN recurrence after transplantation.

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