End-stage kidney disease due to haemolytic uraemic syndrome – outcomes in 241 consecutive ANZDATA registry cases

Tang, Wen, Mohandas, Janaki, McDonald, Stephen P., Hawley, Carmel M., Badve, Sunil V., Boudville, Neil, Brown, Fiona G., Clayton, Philip A., Wiggins, Kathryn J., Bannister, Kym M., Campbell, Scott B. and Johnson, David W. (2012) End-stage kidney disease due to haemolytic uraemic syndrome – outcomes in 241 consecutive ANZDATA registry cases. BMC Nephrology, 13 164.1-164.11. doi:10.1186/1471-2369-13-164

Author Tang, Wen
Mohandas, Janaki
McDonald, Stephen P.
Hawley, Carmel M.
Badve, Sunil V.
Boudville, Neil
Brown, Fiona G.
Clayton, Philip A.
Wiggins, Kathryn J.
Bannister, Kym M.
Campbell, Scott B.
Johnson, David W.
Title End-stage kidney disease due to haemolytic uraemic syndrome – outcomes in 241 consecutive ANZDATA registry cases
Journal name BMC Nephrology   Check publisher's open access policy
ISSN 1471-2369
Publication date 2012-12
Sub-type Article (original research)
DOI 10.1186/1471-2369-13-164
Open Access Status DOI
Volume 13
Start page 164.1
End page 164.11
Total pages 11
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2013
Language eng
Formatted abstract
Background: The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD) secondary to haemolytic uraemic syndrome (HUS).

Methods: The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era.

Results: Of the 58422 patients included in the study, 241 (0.4%) had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34) or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12), but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008). 130 (54%) HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%), 5 years (62% vs 85%) and 10 years (49% vs 73%). HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p < 0.001). Sixteen (12%) HUS patients experienced failure of 22 renal allografts due to recurrent HUS. HUS ESKD was not independently associated with the risk of death following renal transplantation (HR 0.92, 95% CI 0.35-2.44, p = 0.87).

Conclusions: HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.
Keyword Haemolytic uraemic syndrome
Kidney Failure
Renal function recovery
Renal transplantation
Thrombotic microangiopathy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article 164 Published: 3 December 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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