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

Abstract: Background: 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: 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: 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. Immunoglobulin A nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) had the highest incidences, 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 5-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: 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.

 Fuente: Nephrology, Dialysis, Transplantation: Official Publication of The European Dialysis and Transplant Association - European Renal Association, 2024, 39, 1449-1460

 Editorial: Oxford University Press

 Año de publicación: 2024

 Nº de páginas: 12

 Tipo de publicación: Artículo de Revista

 DOI: 10.1093/ndt/gfae034

 ISSN: 0931-0509,1460-2385

 Url de la publicación: https://doi.org/10.1093/ndt/gfae034

Autoría

ELHAFEEZ, SAMAR ABD

KRAMER, ANNEKE

ARICI, MUSTAFA

ARNOL, MIHA

ASBERG, ANDERS

BELL, SAMIRA

BELLIERE, JULIE

DÍAZ CORTE, CARMEN

HEMMELDER, MARC

HEYLEN, LINE

HOMMEL, KRISTINE

KERSCHBAUM, JULIA

NAUMOVIC, RADOMIR

NITSCH, DOROTHEA

SANTAMARIA, RAFAEL

FINNE, PATRICK

PALSSON, RUNOLFUR

PIPPIAS, MARIA

RESIC, HALIMA