Improved survival with renal transplantation for end-stage renal disease due to granulomatosis with polyangiitis: data from the United States Renal Data System

Annals of the Rheumatic Diseases
Zachary S WallaceHyon K Choi

Abstract

Renal transplantation is the optimal treatment for selected patients with end-stage renal disease (ESRD). However, the survival benefit of renal transplantation among patients with ESRD attributed to granulomatosis with polyangiitis (GPA) is unknown. We identified patients from the United States Renal Data System with ESRD due to GPA (ESRD-GPA) between 1995 and 2014. We restricted our analysis to waitlisted subjects to evaluate the impact of transplantation on mortality. We followed patients until death or the end of follow-up. We compared the relative risk (RR) of all-cause and cause-specific mortality in patients who received a transplant versus non-transplanted patients using a pooled logistic regression model with transplantation as a time-varying exposure. During the study period, 1525 patients were waitlisted and 946 received a renal transplant. Receiving a renal transplant was associated with a 70% reduction in the risk of all-cause mortality in multivariable-adjusted analyses (RR=0.30, 95% CI 0.25 to 0.37), largely attributed to a 90% reduction in the risk of death due to cardiovascular disease (CVD) (RR=0.10, 95% 0.06-0.16). Renal transplantation is associated with a significant decrease in all-cause mortality among pa...Continue Reading

References

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Jun 21, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Michelle M O'ShaughnessyWolfgang C Winkelmayer
Sep 2, 2015·Seminars in Arthritis and Rheumatism·Zachary S WallaceHyon K Choi
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Mar 30, 2017·World Journal of Clinical Cases·Eray ErogluOktay Oymak

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Citations

Jan 7, 2019·Annals of the Rheumatic Diseases·Zachary S WallaceUNKNOWN ACR/EULAR IgG4-RD Classification Criteria Committee
Sep 1, 2019·Journal of Nephrology·Michael S SagmeisterUlf Schönermarck
Mar 20, 2020·BMJ : British Medical Journal·Zachary S Wallace, Eli M Miloslavsky
Feb 20, 2020·Kidney & Blood Pressure Research·Zdenka HruskovaDuvuru Geetha

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