Rate of kidney replacement therapy for primary glomerular disease varies by country
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Key takeaways:
- Kidney replacement therapy for primary glomerular disease was 16.6 per million population.
- Highest therapy rates were linked to immunoglobulin A nephropathy and focal segmental glomerulosclerosis.
Rate of kidney replacement therapy for end-stage kidney disease due to primary glomerular disease varies between European countries and was highest for immunoglobulin A nephropathy and focal segmental glomerulosclerosis, study data show.
“Several studies have addressed the incidence, trends and outcomes among patients receiving [kidney replacement therapy] KRT for ESKD secondary to the ‘overall’ [primary glomerular disease] PGD group,” Samar Abd ElHafeez, of the department of medical informatics at the University of Amsterdam in The Netherlands, wrote with colleagues. “However, few studies have investigated either the (trends in) incidence or outcomes of KRT among different PGD subgroups, and none of them compared the incidence and prognosis of KRT for ESKD across all PGD subgroups in multiple European countries.”
Researchers used data from the European Renal Association Registry to examine trends in survival and causes of death for patients starting kidney replacement therapy. Overall, 69,854 patients who began therapy for ESKD due to primary glomerular disease were evaluated from 2000 to 2019. Investigators analyzed age and sex and used primary renal disease codes to define six primary glomerular disease subgroups.
Results showed standardized incidence of kidney replacement therapy for ESKD due to primary glomerular disease was 16.6 per million population. This ranged from 8.6 per million population in Serbia to 20 per million population in France.
Immunoglobulin A nephropathy and focal segmental glomerulosclerosis had the highest incidences: 4.6 per million population and 2.6 per million population, respectively.
More than 50% of cases in Serbia, Bosnia, Herzegovina and Romania were not histologically examined, data showed, and cases were also common in Greece, Estonia, Belgium and Sweden.
Overall, kidney replacement therapies dropped from 18.6 per million population in 2000 to 14.5 per million population in 2013, before stabilizing, according to the researchers.
ElHafeez and colleagues also noted that all primary glomerular disease subgroups had 5-year survival probabilities of more than 50%. Crescentic glomerulonephritis was associated with the highest risk of death (adjusted HR 1.8; 95% CI,1.6-1.9), and cardiovascular disease was the most common mortality cause, making up 33.9% of cases.
“Studying the incidence and outcomes of KRT due to kidney failure for various PGD subgroups helps in understanding their prognosis, which could contribute to the development of a more individualized and equitable patient care approach,” the researchers wrote. They noted that “future studies are warranted to assess the impact of novel therapies on disease progression and the initiation of KRT in PGD patients.”
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