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. 2024 Aug 30;39(9):1449-1460.
doi: 10.1093/ndt/gfae034.

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

Samar Abd ElHafeez  1   2 , Anneke Kramer  1   3 , Mustafa Arici  4 , Miha Arnol  5   6 , Anders Åsberg  7 , Samira Bell  8   9 , Julie Belliere  10 , Carmen Díaz Corte  11 , Gema Fernández Fresnedo  12 , Marc Hemmelder  13   14 , Line Heylen  15   16   17 , Kristine Hommel  18 , Julia Kerschbaum  19 , Radomir Naumović  20 , Dorothea Nitsch  21   22 , Rafael Santamaria  23   24 , Patrik Finne  25 , Runolfur Palsson  26   27 , Maria Pippias  28   29 , Halima Resic  30 , Mai Rosenberg  31 , Carmen Santiuste de Pablos  32   33 , Mårten Segelmark  34   35 , Søren Schwartz Sørensen  36 , Maria Jose Soler  37 , Enrico Vidal  38   39 , Kitty J Jager  1   3 , Alberto Ortiz  40   41 , Vianda S Stel  1   3
Affiliations

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

Samar Abd ElHafeez et al. Nephrol Dial Transplant. .

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.

Keywords: dialysis; epidemiology; kidney replacement therapy; outcome; primary glomerular disease.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Graphical Abstract
Graphical Abstract
Figure 1:
Figure 1:
Standardized incidence of kidney replacement therapy pmp for ESKD due to PGD by country based on 2000–19 data. For age and sex standardization, the EU28 population in 2015 was used. Dark green represents a higher standardized incidence pmp, while light green and yellow represents a lower standardized incidence pmp.
Figure 2:
Figure 2:
Trends in age- and sex-standardized incidence of KRT pmp for ESKD due to PGD, based on 2000–19 data. The APC and 95% CI are indicated in the righthand panel. *Significant change in APC.
Figure 3:
Figure 3:
Five-year survival for patients starting KRT for ESKD due to PGD based on 2000–14 data using Kaplan–Meier survival analyses. Adjustment for age, sex, time period and country.
See this image and copyright information in PMC

References

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