Comparison of cause of death between Australian and New Zealand Dialysis and Transplant Registry and the Australian National Death Index

Sypek, Matthew P.; Dansie, Kathryn; Clayton, Phil; Webster, Angela C; McDonald, S.

doi:10.1111/nep.13250

Cited by 19 publications

(26 citation statements)

References 12 publications

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“…The reporting of cause of death in ANZDATA was reliant on the treating team and was not crossverified with the National Death Index. Prior comparison of the cause of death recorded in ANZDATA with the National Death Index has revealed good correlation for the timing of death, and fair agreement in the coding of cause of death, with the best agreement found for cancer-related deaths (28). There was also limited granularity of data collection and no information pertaining to transplant management protocols, changes in immunosuppression after transplant, or treatment adherence.…”

Section: Discussionmentioning

confidence: 99%

Survival after Kidney Transplantation during Childhood and Adolescence

Francis¹,

Johnson²,

Melk³

et al. 2020

CJASN

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Background and objectivesSurvival in pediatric kidney transplant recipients has improved over the past five decades, but changes in cause-specific mortality remain uncertain. The aim of this retrospective cohort study was to estimate the associations between transplant era and overall and cause-specific mortality for child and adolescent recipients of kidney transplants.Design, setting, participants, & measurementsData were obtained on all children and adolescents (aged <20 years) who received their first kidney transplant from 1970 to 2015 from the Australian and New Zealand Dialysis and Transplant Registry. Mortality rates were compared across eras using Cox regression, adjusted for confounders.ResultsA total of 1810 recipients (median age at transplantation 14 years, 58% male, 52% living donor) were followed for a median of 13.4 years. Of these, 431 (24%) died, 174 (40%) from cardiovascular causes, 74 (17%) from infection, 50 (12%) from cancer, and 133 (31%) from other causes. Survival rates improved over time, with 5-year survival rising from 85% for those first transplanted in 1970–1985 (95% confidence interval [95% CI], 81% to 88%) to 99% in 2005–2015 (95% CI, 98% to 100%). This was primarily because of reductions in deaths from cardiovascular causes (adjusted hazard ratio [aHR], 0.25; 95% CI, 0.08 to 0.68) and infections (aHR, 0.16; 95% CI, 0.04 to 0.70; both for 2005–2015 compared with 1970–1985). Compared with patients transplanted 1970–1985, mortality risk was 72% lower among those transplanted 2005–2015 (aHR, 0.28; 95% CI, 0.18 to 0.69), after adjusting for potential confounders.ConclusionsSurvival after pediatric kidney transplantation has improved considerably over the past four decades, predominantly because of marked reductions in cardiovascular- and infection-related deaths.

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Section: Discussionmentioning

confidence: 99%

Survival after Kidney Transplantation during Childhood and Adolescence

Francis¹,

Johnson²,

Melk³

et al. 2020

CJASN

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“…We conducted a population‐based cohort study of kidney transplant recipients using the Australian and New Zealand Dialysis and Transplantation Registry (ANZDATA). ANZDATA is a binational registry in operation since the inception of end‐stage kidney disease treatment in Australia and New Zealand, recording demographic, clinical and outcome data for all those in country receiving treatment …”

Section: Methodsmentioning

confidence: 99%

“…ANZDATA is a binational registry in operation since the inception of end-stage kidney disease treatment in Australia and New Zealand, recording demographic, clinical and outcome data for all those in country receiving treatment. 11 To determine the fact and cause of death, we linked ANZDATA with national death registers in Australia and New Zealand. In both countries', fact and cause of death reporting are mandatory.…”

Section: Study Cohortmentioning

confidence: 99%

Cancer mortality in kidney transplant recipients: An Australian and New Zealand population‐based cohort study, 1980–2013

Rosales

Mata

Vajdic

et al. 2019

Intl Journal of Cancer

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Cancer burden is increasing in kidney transplant recipients, but differences in mortality compared to the general population remain unclear. We sought to compare cancer mortality in paediatric and adult kidney transplant recipients with the general population and describe any differences, by site, age and sex, country and over time. We included kidney transplant recipients from the Australian and New Zealand Dialysis and Transplantation Registry, 1980–2013. Date of death and underlying cause of death were ascertained by data‐linkage and classified using ICD10AM codes. Indirect standardisation was used to estimate standardised mortality ratios (SMR). There were 5,284 deaths in 17,628 kidney transplant recipients over 175,084 person‐years of observation, including 1,061 (20%) cancer deaths. Relative cancer mortality was higher than the general population for all‐site (SMR 2.9, 95% CI 2.7–3.1) cancer and highest for nonmelanoma skin cancer (SMR 50.9, 95% CI 43.5–59.6) and lymphoma (SMR 42.2, 95% CI 35.3–50.5). Relative cancer mortality decreased with increasing age in men (p < 0.001) and women (p = 0.001) but never reached parity with the general population. Relative mortality did not change with age for skin and lip, or colorectal cancers (p‐value >0.1). Only relative colorectal cancer mortality increased over time (p = 0.002). Our study shows cancer mortality in kidney transplant recipients was higher than expected in the general population. The magnitude of excess mortality varied by cancer site, age and sex. Further evidence is needed to identify whether this variation is due to differences at diagnosis or access and effectiveness of cancer treatments in this population.

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“…12 Previous analyses have shown that cancer records within the ANZDATA Registry are robust and accurate, with a high concordance rate when compared with cancer incidence and mortality records reported to the New South Wales Cancer Registry 13 and the Australian National Death Index. 14 We included all cancer diagnoses and cancer deaths in adult patients (age 20 years old or older) except for nonmelanoma skin cancer, premalignant, or in situ lesions in our analyses. Date and causes of death as recorded in the ANZDATA Registry were also included.…”

Section: Ascertainment Of Cancer Deathmentioning

confidence: 99%

Overall and Site-Specific Cancer Mortality in Patients on Dialysis and after Kidney Transplant

Chapman

Craig

et al. 2019

JASN

Self Cite

102

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Background Patients with ESRD have a substantially increased cancer risk, but few studies have examined the patterns of cancer mortality along a patient's journey from dialysis to transplantation. MethodsWe identified all Australian patients on dialysis and patients with transplants from 1980 to 2014 from the Australia and New Zealand Dialysis and Transplant Registry. Using standardized mortality ratios (SMRs), we compared cancer mortality among patients on dialysis and patients with transplants versus the general population (overall and by age, sex, year, and site); we also performed a subgroup analysis excluding patients with preexisting cancers. ResultsWe followed 52,936 patients on dialysis and 16,820 transplant recipients for 170,055 and 128,352 patient-years, respectively. There were 2739 cancer deaths among patients on dialysis and 923 cancer deaths among transplant recipients. Overall, cancer SMRs were 2.6 for patients on dialysis and 2.7 for transplant recipients. For patients on dialysis, SMRs were highest for multiple myeloma (30.5), testicular cancer (17.0), and kidney cancer (12.5); for transplant recipients, SMRs were highest for non-Hodgkin lymphoma (10.7), kidney cancer (7.8), and melanoma (5.8). Some 61.0% of patients on dialysis and 9.6% of transplant recipients who experienced cancer death had preexisting cancer. The SMRs for de novo cancer was 1.2 for patients on dialysis and 2.6 for transplant recipients.Conclusions Patients on dialysis and transplant recipients experienced .2.5-fold increased risk of cancer death compared with the general population. This increased risk was largely driven by preexisting cancers in patients on dialysis and de novo cancers in patients with transplants.

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Comparison of cause of death between Australian and New Zealand Dialysis and Transplant Registry and the Australian National Death Index

Cited by 19 publications

References 12 publications

Survival after Kidney Transplantation during Childhood and Adolescence

Survival after Kidney Transplantation during Childhood and Adolescence

Cancer mortality in kidney transplant recipients: An Australian and New Zealand population‐based cohort study, 1980–2013

Overall and Site-Specific Cancer Mortality in Patients on Dialysis and after Kidney Transplant

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