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Mortality Improving in Those with ESRD Due to GPA

Arthritis Care Res; ePub 2018 Jan 23; Wallace, et al

Researchers found significant improvements in mortality among patients with granulomatosis with polyangiitis-end-stage renal disease (GPA-ESRD), in a recent study of nearly all patients who developed ESRD due to GPA in the US over 2 decades. In addition, cause-specific death due to cardiovascular disease (CVD) and infections each declined significantly during the study period. They identified ESRD due to GPA in the US Renal Data System (USRDS) between 1995 and 2014. The cohort was divided into 4 5-year subcohorts based on year of ESRD onset (1995-1999; 2000-2004; 2005-2009; 2010-2014) to assess trends in mortality rates and hazard ratios (HRs) for overall death and cause-specific death, adjusting for potential confounders. Researchers found:

  • Between 1995 and 2014, there were 5,929 incident cases of GPA-ESRD.
  • The mortality rate (per 100 patient-years) declined from 19.0 in 1995-1999 to 15.3 in 2010-2014.
  • The adjusted mortality HR of the 2010-2014 cohort was 0.77, compared with the 1995-1999 cohort.
  • The corresponding cause-specific mortality HRs after accounting for competing risk were 0.61 for CVD death and 0.42 for infection death.

Wallace ZS, Zhang Y, Lu N, Stone JH, Choi HK. Improving mortality in end-stage renal disease due to granulomatosis with polyangiitis from 1995 to 2014. [Published online ahead of print January 23, 2018]. Arthritis Care Res; doi:10.1002/acr.23521.

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