- End-stage renal disease (ESRD) secondary to membranous nephropathy (MN) is associated with superior survival with dialysis or kidney transplant (KT) compared with ESRD with other etiologies.
Why this matters
- Compared with other forms of glomerulonephritis (GN), MN was tied to greater death-censored graft loss driven by primary disease recurrence.
- Registry-based study of 32,788 patients initiating renal replacement therapy in Australia and New Zealand during 1998-2010; 1.27% had MN.
- Funding: None.
- Among patients on dialysis, adjusted survival rates were higher with MN vs other etiologies at 1 (98% vs 93%), 5 (81% vs 65%) and 10 years (58% vs 36%).
- MN was associated with:
- 21% lower mortality risk on dialysis vs other ESRD (aHR=0.79; P=.002);
- 43% lower mortality risk after KT vs other ESRD (aHR=0.57; P=.04); and
- Similar survival vs other forms of GN (P=.42; P=.11).
- Among dialysis-treated patients, MN was tied to a greater likelihood of KT than other ESRD etiologies (subhazard [S]HR=1.48; P<.001 or forms of gn>
- MN was tied to greater post-KT primary recurrence than other ESRD etiologies (aHR=4.92; P<.001 and forms of gn>
- In competing-risk analysis, death-censored graft loss was higher with MN than other types of ESRD (SHR=1.59; P=.02) and GN (SHR=1.63; P=.02).
- Retrospective design.