Age- and time-dependent increases in incident anti-glomerular basement membrane disease : a nationwide cohort study
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA..
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 4:1 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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Clinical kidney journal - 17(2024), 1 vom: 28. Jan., Seite sfad261 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nelveg-Kristensen, Karl Emil [VerfasserIn] |
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| Links: |
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| Themen: |
Age |
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| Anmerkungen: |
Date Revised 09.01.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ckj/sfad261 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366775014 |
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| 100 | 1 | |a Nelveg-Kristensen, Karl Emil |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Age- and time-dependent increases in incident anti-glomerular basement membrane disease |b a nationwide cohort study |
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| 500 | |a Date Revised 09.01.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. | ||
| 520 | |a 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 | ||
| 520 | |a Methods: All patients with incident anti-GBM disease were identified using the International Classification of Diseases, 10th Revision code DM31.0A. Controls were matched 4:1 on birthyear and sex using exposure density sampling. Log link regression adjusted for time, age and sex was applied to model survival | ||
| 520 | |a 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] | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a age | |
| 650 | 4 | |a analysis | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a gender | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a survival | |
| 700 | 1 | |a Madsen, Bo |e verfasserin |4 aut | |
| 700 | 1 | |a McClure, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Bruun, Nanna |e verfasserin |4 aut | |
| 700 | 1 | |a Lyngsø, Cecilie |e verfasserin |4 aut | |
| 700 | 1 | |a Dieperink, Hans |e verfasserin |4 aut | |
| 700 | 1 | |a Gregersen, Jon Waarst |e verfasserin |4 aut | |
| 700 | 1 | |a Krarup, Elizabeth |e verfasserin |4 aut | |
| 700 | 1 | |a Ivarsen, Per |e verfasserin |4 aut | |
| 700 | 1 | |a Torp-Pedersen, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Egfjord, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Szpirt, Wladimir |e verfasserin |4 aut | |
| 700 | 1 | |a Carlson, Nicholas |e verfasserin |4 aut | |
| 700 | 0 | |a Danish Vasculitis Association (DANVAS) |e verfasserin |4 aut | |
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