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Age- and time-dependent increases in incident anti-glomerular basement membrane disease: a nationwide cohort study.
Nelveg-Kristensen, Karl Emil; Madsen, Bo; McClure, Mark; Bruun, Nanna; Lyngsø, Cecilie; Dieperink, Hans; Gregersen, Jon Waarst; Krarup, Elizabeth; Ivarsen, Per; Torp-Pedersen, Christian; Egfjord, Martin; Szpirt, Wladimir; Carlson, Nicholas.
Afiliación
  • Nelveg-Kristensen KE; Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Madsen B; Department of Nephrology, SLE and Vasculitis Clinic, Aalborg University Hospital, Aalborg, Denmark.
  • McClure M; Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
  • Bruun N; Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Lyngsø C; Department of Nephrology, Zealand University Hospital, Roskilde, Denmark.
  • Dieperink H; Department of Nephrology, Odense University Hospital, Odense, Denmark.
  • Gregersen JW; Department of Nephrology, SLE and Vasculitis Clinic, Aalborg University Hospital, Aalborg, Denmark.
  • Krarup E; Department of Nephrology, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
  • Ivarsen P; Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark.
  • Torp-Pedersen C; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  • Egfjord M; Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark.
  • Szpirt W; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Carlson N; Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Clin Kidney J ; 17(1): sfad261, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38186880
ABSTRACT

Background:

Epidemiologic assessments of anti-glomerular basement membrane (GBM) disease have been challenging due to its rare occurrence. We examined changes in the incidence and outcomes from 1998 to 2018 using nationwide healthcare registries.

Methods:

All patients with incident anti-GBM disease were identified using the International Classification of Diseases, 10th Revision code DM31.0A. Controls were matched 41 on birthyear and sex using exposure density sampling. Log link regression adjusted for time, age and sex was applied to model survival.

Results:

We identified 97 patients with incident anti-GBM disease, corresponding to an incidence of 0.91 cases/million/year [standard deviation (SD) 0.6]. The incidence increased over time [1998-2004 0.50 (SD 0.2), 2005-2011 0.80 (SD 0.4), 2012-2018 1.4 (SD 0.5); P = .02] and with age [0.76 (SD 0.4), 1.5 (SD 1.04) and 4.9 (SD 2.6) for patients <45, 45-75 and >75 years]. The median age was 56 years (interquartile range 46) and 51.6% were female. Dialysis was required in 58.4%, 61.9% and 62.9% of patients at day 30, 180 and 360, respectively. The 1-year kidney survival probability was 0.38 (SD 0.05) and exhibited time-dependent changes [1998-2004 0.47 (SD 0.13), 2005-2011 0.16 (SD 0.07), 2012-2018 0.46 (SD 0.07); P = .035]. The 5-year mortality was 26.8% and mortality remained stable over time (P = .228). The risk of death was greater than that of the matched background population {absolute risk ratio [ARR] 5.27 [confidence interval (CI) 2.45-11.3], P < .001}, however, it was comparable to that of patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) requiring renal dialysis at presentation [ARR 0.82 (CI 0.48-1.41), P = .50].

Conclusion:

The incidence of anti-GBM disease increased over time, possibly related to temporal demographic changes. Mortality remained high and was comparable with an age- and sex-matched cohort of dialysis-dependent AAV patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido