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4 days ago

Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

2 days ago
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Renal transplant improves survival among lupus nephritis patients with ESRD

08 Feb 2019
Hospital Authority is set to introduce a pair exchange scheme for kidney transplants by the second half of 2018.

Renal transplantation confers survival benefits to patients with end-stage renal disease (ESRD) due to lupus nephritis (LN), driven primarily by reduced deaths from cardiovascular disease and infection, a study has shown.

“The findings highlight the benefit of timely referral for transplant to improve outcomes in this population,” the investigators said.

Of the 9,659 patients with LN-ESRD who were waitlisted for a renal transplant during the study period, 5,738 (59 percent) had a transplant. Most patients were female (82 percent) and nonwhite (60 percent).

Among waitlisted patients, an association was found between transplant and reduced all-cause mortality (adjusted hazard ratio [HR], 0.30; 95 percent CI, 0.270.33). Adjusted HRs for cause-specific mortality were as follows: 0.26 (0.23‒0.30) for cardiovascular disease, 0.30 (0.19‒0.48) for coronary heart disease, 0.41 (0.32‒0.52) for infection and 0.41 (0.31‒0.53) for sepsis.

To examine the potential effect of renal transplant on survival, this nationwide cohort study enrolled patients with incident LN-ESRD who were waitlisted for a renal transplant. Analysis was conducted on first renal transplant as a time-varying exposure.

All-cause and cause-specific mortality were the primary outcomes. The investigators used time-dependent Cox regression analysis to estimate the HR of these outcomes associated with renal transplant in the primary analysis. Sequential cohort matching was used in a secondary analysis limited to patients with Medicare, which allowed assessment of time-varying covariates.

The study was limited by unmeasured factors that could have contributed to the observed associations. However, the E-value analysis suggested robustness of the findings, according to the investigators.

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Most Read Articles
4 days ago

Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

2 days ago
Susceptibility‐guided therapy is as effective as empiric modified bismuth quadruple therapy for the first-line treatment of Helicobacter pylori infection, with both yielding excellent eradication rates, as shown in a recent trial.
4 days ago
It appears that long-term consumption of fish and omega-3 fatty acid does not influence the risk of incident hypertension in middle-aged and older men, suggests a US study.
2 days ago
The risk factors and outcomes associated with an increased risk of permanent pacing include atrial fibrillation (AF) ablation, multivalve surgery and New York Heart Association (NYHA) functional class III/IV, a recent study has found.