Abstract: SA-PO296
Outcomes of Australian and New Zealand Dialysis and Transplant Patients with Kidney Failure Attributed to Kidney Stones
Session Information
- Bone and Mineral Metabolism: Stones, Calcifications, Case Reports
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Cheikh Hassan, Hicham I., University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Tunnicliffe, David J., The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Lloyd, Lyn, Auckland City Hospital, Auckland, Auckland, New Zealand
- Yip, Adela, The University of Sydney, Sydney, New South Wales, Australia
- Cashmore, Brydee, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Mullan, Adam W.F., The University of Auckland, Auckland, New Zealand
- Jose, Matthew D., Royal Hobart Hospital, Hobart, Tasmania, Australia
- Mallett, Andrew John, Townsville Hospital and Health Service, Townsville, Queensland, Australia
Background
Prevalence of kidney stones in the general population can reach 15-20%. Kidney stone formers (KSF), compared to non-KSF, have an increased risk of developing chronic kidney disease and kidney failure (KF). While risk factors, aetiology and outcomes in KSF is well established there remains little data for patients after they develop KF. We therefore set out to examine outcomes of KSF with KF (transplant or recieving dialysis).
Methods
Using the Australian and New Zealand Dialysis and Transpant (ANZDATA) registry we included adult patients with KF who recieved dialysis or transplant (1973-2020). We divided our cohort into KSF and non-KSF groups. For dialysis, we included haemodialysis and peritoneal dialysis to determine risk of mortality. A joinpoint model examined annual rates of KSF diagnosed with KF over time. A seperate analysis was conducted for transplant recipients to examine risk of mortaity and graft failure. Multivariate Cox regression analysis was used to determine hazard ratio (HR) and 95% confidence interval (CI) of outcomes.
Results
In the dialysis cohort 79,670 patients were followed (293,255 patient-years) with 871 (1.1%) having KF from calculi. Compared to non-KSF the KSF group were less likely to have diabetes (26%vs45%) or vascular disease (17%vs45%) and were older (61vs58 years), P<0.001. Proportion of KF with calculi as a cause declined annually by 2.7% (95%CI 1.9-7.4, P<0.01). There was no difference in mortality between KSF and non-KSF in patients in multivariate analysis (HR 0.93, 95%CI 0.86- 1.01, P<0.001).
In the transplant cohort 25,052 patients were included, with 219 (0.9%) having KF from calculi. Pre-emptive transplant occurred in 2,221 (2.7%) of the whole group but only in 12 (1.3%) of KSF. Compared to the non-KSF the KSF group were less likely to be diabetic (20%vs12%) and older (48 vs 51 years) (P<0.001). There was no difference in mortality risk (HR 1.04, 95%CI 0.86-1.26) or graft failure (HR 1.01, 95%CI 0.77-1.34) between the two groups in multivariate analysis.
Conclusion
In Australia and New Zealand, KSF as a cause of KF is rare and declining over time. There is no difference in mortality risk between KSF and non-KSF in patients who start dialysis, or a difference in graft failure rate in those who received a transplant.