@article{Wyld2023,

title = {Life Years Lost in Children with Kidney Failure: A Binational Cohort Study with Multistate Probabilities of Death and Life Expectancy},

author = {Melanie L. Wyld and Nicole L. De La Mata and James Hedley and Siah Kim and Patrick J. Kelly and Angela C. Webster},

doi = {10.1681/asn.0000000000000118},

issn = {1533-3450},

year  = {2023},

date = {2023-00-00},

urldate = {2023-00-00},

journal = {JASN},

volume = {34},

number = {6},

pages = {1057--1068},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {<jats:sec><jats:title>Significance Statement</jats:title><jats:p>In children with kidney failure, little is known about their treatment trajectories or the effects of kidney failure on lifetime survival and years of life lost, which are arguably more relevant measures for children. In this population-based cohort study of 2013 children who developed kidney failure in Australia and New Zealand, most children were either transplanted after initiating dialysis (74%) or had a preemptive kidney transplant (14%). Life expectancy increased with older age at kidney failure, but more life years were spent on dialysis than with a functioning transplant. The expected (compared with the general population) number of life years lost ranged from 16 to 32 years, with female patients and those who developed kidney failure at a younger age experiencing the greatest loss of life years.</jats:p></jats:sec><jats:sec><jats:title>Background</jats:title><jats:p>Of the consequences of kidney failure in childhood, those rated as most important by children and their caregivers are its effects on long-term survival. From a life course perspective, little is known about the experience of kidney failure treatment or long-term survival.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>To determine expected years of life lost (YLL) and treatment trajectory for kidney failure in childhood, we conducted a population-based cohort study of all children aged 18 years or younger with treated kidney failure in Australia (1980–2019) and New Zealand (1988–2019).We used patient data from the CELESTIAL study, which linked the Australian and New Zealand Dialysis and Transplant registry with national death registers. We estimated standardized mortality ratios and used multistate modeling to understand treatment transitions and life expectancy.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 394 (20%) of 2013 individuals died over 30,082 person-years of follow-up (median follow-up, 13.1 years). Most children (74%) were transplanted after initiating dialysis; 14% (18% of male patients and 10% of female patients) underwent preemptive kidney transplantation. Excess deaths (compared with the general population) decreased dramatically from 1980 to 1999 (from 41 to 22 times expected) and declined more modestly (to 17 times expected) by 2019. Life expectancy increased with older age at kidney failure, but more life years were spent on dialysis than with a functioning transplant. The number of YLL ranged from 16 to 32 years, with the greatest loss among female patients and those who developed kidney failure at a younger age.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Children with kidney failure lose a substantial number of their potential life years. Female patients and those who develop kidney failure at younger ages experience the greatest burden.</jats:p></jats:sec>},

keywords = {Other CODE work},

pubstate = {published},

tppubtype = {article}

}

@article{Campbell2022,

title = {Interventions for improving health literacy in people with chronic kidney disease},

author = {Zoe C Campbell and Jessica K Dawson and Suzanne M Kirkendall and Kirsten J McCaffery and Jesse Jansen and Katrina L Campbell and Vincent WS Lee and Angela C Webster},

editor = { },

doi = {10.1002/14651858.cd012026.pub2},

issn = {1465-1858},

year  = {2022},

date = {2022-12-00},

urldate = {2022-12-00},

volume = {2022},

number = {12},

publisher = {Wiley},

keywords = {Other CODE work},

pubstate = {published},

tppubtype = {article}

}

@article{Hedley2022,

title = {Patient and kidney transplant survival in type 1 diabetics after kidney transplant alone compared to simultaneous pancreas‐kidney transplant},

author = {James A. Hedley and Patrick J. Kelly and Angela C. Webster},

doi = {10.1111/ans.17663},

issn = {1445-2197},

year  = {2022},

date = {2022-07-00},

urldate = {2022-07-00},

journal = {ANZ Journal of Surgery},

volume = {92},

number = {7-8},

pages = {1856--1862},

publisher = {Wiley},

abstract = {<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Donor and other differences mean understanding drivers of transplant survival for type 1 diabetics is challenging. We aimed to compare outcomes of simultaneous pancreas‐kidney transplant over kidney transplant alone for people with end‐stage kidney disease (ESKD) and type 1 diabetes.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We performed a population‐based cohort study comparing outcomes from kidney alone and kidney‐pancreas transplants using registry data. Our study population was people in Australia and New Zealand with type 1 diabetes and ESKD who received a kidney transplant in 1984–2016. Primary outcomes were time to kidney transplant failure and all‐cause death. Secondary outcomes were time to cardiovascular and non‐cardiovascular death. We compared adjusted survival using Cox regression (hazard ratio HR and 95% confidence intervals CI).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 1295 type 1 diabetics receiving a transplant, 430 (33%) received deceased donor kidney, 172 (13%) received living donor kidney, and 693 (54%) received pancreas‐kidney transplant. Compared to deceased donor kidney, pancreas‐kidney recipients had 40% lower rate of kidney transplant failure (adjusted HR 0.60; 95% CI 0.45–0.81; <jats:italic>p</jats:italic> = 0.001) and 34% lower mortality (adjusted HR 0.66; 95% CI 0.53–0.83; <jats:italic>p</jats:italic> < 0.001), driven by 49% reduction in cardiovascular mortality (adjusted HR 0.51; 95% CI 0.36–0.72; <jats:italic>p</jats:italic> < 0.001). Pancreas‐kidney recipients had similar reductions in transplant failure and mortality compared to living kidney recipients, after adjusting for transplant timing.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>For people with type 1 diabetes, pancreas‐kidney transplant provides improved transplant and overall survival compared to deceased donor kidney alone. Living donor kidneys may perform just as well as pancreas‐kidney transplant if waiting times are short.</jats:p></jats:sec>},

keywords = {Other CODE work},

pubstate = {published},

tppubtype = {article}

}

@article{Rosales2021,

title = {Prevalence of anal cytological abnormalities and high‐risk human papillomavirus prevalence in kidney transplant recipients: A cross‐sectional study},

author = {Brenda M. Rosales and Julian Langton‐Lockton and James Hedley and Alyssa M. Cornall and Jennifer M. Roberts and Suzanne M. Garland and Patrick J. Kelly and Richard J. Hillman and Angela C. Webster},

doi = {10.1111/ctr.14476},

issn = {1399-0012},

year  = {2021},

date = {2021-12-00},

urldate = {2021-12-00},

journal = {Clinical Transplantation},

volume = {35},

number = {12},

publisher = {Wiley},

abstract = {<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Transplant recipients are at high‐risk of anal squamous cell cancer. We aimed to estimate the prevalence of high‐risk human papillomavirus (HPV) and high‐grade squamous intraepithelial lesion (HSIL) and assess characteristics associated with results</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We recruited kidney transplant recipients in a single‐center, 2015–2018. Participants completed a clinical questionnaire and received an anal‐swab sent for HPV‐DNA and cytological testing</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 97 (74%) of 125 recipients approached consented to participate. Participants were median 47 (IQR 40–55) years, 60% male and median 4.5 (IQR .9‐13) months‐since‐transplant. Of 86 assessable samples, at least one HPV genotype was detected in 15 (17%) participants; 1 (1%) HPV16, 8 (9%) other high‐risk HPV. Of 76 assessable cytology samples, 9 (12%) showed evidence of abnormality; 1 (1%) HSIL, 1 (1%) atypical‐squamous‐cells, cannot exclude HSIL. Both HSIL recipients had high‐risk HPV and biopsy confirmed HSIL. High‐risk HPV was detected in six (9%) recipients with normal cytology. History of sexually transmitted infection, and abnormal cervical pap smear in women, was associated with high‐risk HPV and HSIL</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>High‐risk HPV and HSIL testing may identify kidney transplant recipients at higher risk of anal cancer. Longitudinal studies are needed to describe the natural history of anal cancer in transplant recipients.</jats:p></jats:sec>},

keywords = {Other CODE work},

pubstate = {published},

tppubtype = {article}

}