title: End-stage kidney disease due to haemolytic uraemic syndrome--outcomes in 241 consecutive ANZDATA registry cases.
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.
authors.affiliation: ANZDATA Registry, Adelaide, Australia.
authors.forename: Wen
authors.initials: W
authors.lastname: Tang
authors.forename: Janaki
authors.initials: J
authors.lastname: Mohandas
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McDonald
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Hawley
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Badve
authors.forename: Neil
authors.initials: N
authors.lastname: Boudville
authors.forename: Fiona G
authors.initials: FG
authors.lastname: Brown
authors.forename: Philip A
authors.initials: PA
authors.lastname: Clayton
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Wiggins
authors.forename: Kym M
authors.initials: KM
authors.lastname: Bannister
authors.forename: Scott B
authors.initials: SB
authors.lastname: Campbell
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012042:Registries; D017582:Renal Replacement Therapy / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult