End-stage renal failure due to amyloidosis: outcomes in 490 ANZDATA registry cases

Tang, Wen, McDonald, Stephen P., Hawley, Carmel M., Badve, Sunil V., Boudville, Neil, Brown, Fiona G., Clayton, Philip A., Campbell, Scott B., de Zoysa, Janak R. and Johnson, David W. (2013) End-stage renal failure due to amyloidosis: outcomes in 490 ANZDATA registry cases. Nephrology Dialysis Transplantation, 28 2: 455-461. doi:10.1093/ndt/gfs492

Author Tang, Wen
McDonald, Stephen P.
Hawley, Carmel M.
Badve, Sunil V.
Boudville, Neil
Brown, Fiona G.
Clayton, Philip A.
Campbell, Scott B.
de Zoysa, Janak R.
Johnson, David W.
Title End-stage renal failure due to amyloidosis: outcomes in 490 ANZDATA registry cases
Journal name Nephrology Dialysis Transplantation   Check publisher's open access policy
ISSN 0931-0509
Publication date 2013-02
Year available 2012
Sub-type Article (original research)
DOI 10.1093/ndt/gfs492
Volume 28
Issue 2
Start page 455
End page 461
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2013
Language eng
Formatted abstract
Background: There are few reports regarding the long-term renal replacement therapy (RRT) outcomes of amyloidosis.

Methods: In this retrospective, multi-centre, multi-country registry analysis, all patients with and without amyloidosis who commenced RRT for end-stage renal failure (ESRF) in Australia and New Zealand between 1963 and 2010 were included.

Results: Of 58 422 patients who underwent RRT during the study period, 490 (0.8%) had ESRF secondary to amyloidosis. The median survival of amyloidosis patients on dialysis (2.09 years, 95% CI 1.85-2.32 years) was significantly inferior to that of patients with other causes of ESRF (4.45 years, 95% CI 4.39-4.51 years) (log-rank score 242, P < 0.001). The survival of amyloidosis patients receiving peritoneal dialysis (1.9 years, 95% CI 1.58-2.22) was comparable with those receiving haemodialysis (2.17 years, 95% CI 1.89-2.45) (P = 0.18). Fifty-three (13.8%) amyloidosis patients died of amyloidosis complications. Forty-six patients underwent renal transplantation with first graft survival rates of 45% at 5 years and 26% at 10 years. Nine (16.4%) patients experienced amyloidosis recurrence in their allografts, which led to graft failure in six patients. ESRF patients with amyloidosis experienced inferior median first renal allograft survival (4.55 years, 95% CI 1.96-7.15 versus 10.7 years, 95% CI 10.5-11.0, P = 0.001) and transplant patient survival (6.03 years, 95% CI 2.71-9.36 versus 16.8 years, 95% CI 16.4-17.1, P < 0.001) compared with patients with other causes of ESRF. Respective 10-year patient survival rates were 37 and 69%.

Conclusions: Amyloidosis was associated with poor patient survival following dialysis and/or renal transplantation, poor renal allograft survival and a significant incidence of disease recurrence in the allograft. An appreciable proportion of amyloid ESRF patients died of amyloidosis-related complications.
Keyword Amyloidosis
End-stage renal failure
Renal transplantation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Advance access publication: 25 November 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
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