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Kidney Week

Abstract: FR-PO632

Patient Mortality and Graft Failure Risks in Transplant Recipients with Kidney Failure Secondary to Genetic Kidney Disease Compared to People with Other Kidney Diseases

Session Information

Category: Genetic Diseases of the Kidneys

  • 1202 Genetic Diseases of the Kidneys: Non-Cystic

Authors

  • Ng, Monica S., Kidney Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  • Han, Helen, Kidney Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  • Vangaveti, Venkat, James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia
  • Jose, Matthew D., University of Tasmania Hobart Clinical School, Hobart, Tasmania, Australia
  • Mallett, Andrew John, James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia
Background

There is limited population-level data on long term outcomes of people with genetic kidney disease (GKD) after kidney transplantation. This study aimed to characterise clinical outcomes in people with GKD after kidney transplantation and compare them to those of people with other kidney diseases.

Methods

Data on first kidney transplants between 1 January, 1989 and 31 December, 2020 were extracted from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry. GKDs were classified as majority or minority monogenic. People with other primary kidney diseases were included as the comparator group. Outcome measures were mortality and graft failure. Unadjusted and adjusted hazard ratios (AHRs) were calculated using Cox proportional hazard regression models. Sensitivity analyses were completed to test the effect of major diagnoses (e.g. autosomal polycystic kidney disease and reflux nephropathy) within GKD groups.

Results

21,860 transplant recipients were included. GKDs were associated with reduced mortality in kidney transplant recipients on univariable analyses. This correlation was not statistically significant on multivariable analyses (majority monogenic AHR 0.92, 95% CI 0.84-1.00; minority monogenic AHR 0.91, 95% 0.82-1.02). Majority monogenic GKDs correlated with reduced graft failure compared to other kidney diseases on univariable (Figure 1) and multivariable analyses (AHR 0.79, 95% CI 0.71-0.87). This result was attributed to reduced graft failure in recipients with polycystic kidney disease which constituted 91.9% of the majority monogenic GKD group.

Conclusion

This binational registry analysis found that people with GKD had similar mortality but reduced graft failure after kidney transplant. This is the first study to provide a broad longitudinal overview of clinical outcomes in kidney transplant recipients with GKD.

Figure 1 – Kaplan Meier curve for graft failure in kidney transplant recipients