@article{Shah2024,

title = {Cost-effectiveness of Accepting Kidneys From Deceased Donors With Common Cancers—A Modeling Study},

author = {Karan K. Shah and James A. Hedley and Kristy P. Robledo and Melanie Wyld and Angela C. Webster and Rachael L. Morton},

doi = {10.1097/tp.0000000000004984},

issn = {0041-1337},

year  = {2024},

date = {2024-03-19},

urldate = {2024-03-19},

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

abstract = {<jats:sec>

            <jats:title>Background.</jats:title>

            <jats:p>The disparity between the demand for and supply of kidney transplants has resulted in prolonged waiting times for patients with kidney failure. A potential approach to address this shortage is to consider kidneys from donors with a history of common cancers, such as breast, prostate, and colorectal cancers.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Methods.</jats:title>

            <jats:p>We used a patient-level Markov model to evaluate the outcomes of accepting kidneys from deceased donors with a perceived history of breast, prostate, or colorectal cancer characterized by minimal to intermediate transmission risk. Data from the Australian transplant registry were used in this analysis. The study compared the costs and quality-adjusted life years (QALYs) from the perspective of the Australian healthcare system between the proposed practice of accepting these donors and the conservative practice of declining them. The model simulated outcomes for 1500 individuals waitlisted for a deceased donor kidney transplant for a 25-y horizon.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Results.</jats:title>

            <jats:p>Under the proposed practice, when an additional 15 donors with minimal to intermediate cancer transmission risk were accepted, QALY gains ranged from 7.32 to 20.12. This translates to an approximate increase of 7 to 20 additional years of perfect health. The shift in practice also led to substantial cost savings, ranging between $1.06 and $2.3 million.</jats:p>

          </jats:sec>

          <jats:sec>

            <jats:title>Conclusions.</jats:title>

            <jats:p>The proposed practice of accepting kidneys from deceased donors with a history of common cancers with minimal to intermediate transmission risk offers a promising solution to bridge the gap between demand and supply. This approach likely results in QALY gains for recipients and significant cost savings for the health system.</jats:p>

          </jats:sec>},

keywords = {MODUS, Nephrology, Transplantation},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Relative survival in patients with cancer and kidney failure},

author = {Laia Oliveras and Brenda Maria Rosales and Nicole De La Mata and Claire Vajdic and Nuria Montero and Josep Cruzado and Angela Webster },

doi = { https://doi.org/10.1093/ndt/gfae046},

year  = {2024},

date = {2024-02-21},

urldate = {2024-02-21},

journal = {Nephrology Dialysis Transplantation},

keywords = {Cancer Research, Nephrology, Other CODE work},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Sex differences in the diagnosis of advanced cancer and subsequent outcome in people with chronic kidney disease: an analysis of a national population cohort},

author = {R Shemilt and MK Sullivan and P Hanlon and B Jani and N De La Mata and B Rosales and BMP Elyan and M Wyld and JA Hedley and R Cutting and DA McAllister and AC Webster and PB Mark and JS Lees},

doi = {https://doi.org/10.1101/2023.08.22.23294412},

year  = {2023},

date = {2023-08-22},

urldate = {2023-08-22},

journal = {Nephrology Dialysis Transplantation},

keywords = {Cancer Research, Nephrology, SHE-ROCKS},

pubstate = {published},

tppubtype = {article}

}

@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 = {General Medicine, Nephrology, Other CODE work},

pubstate = {published},

tppubtype = {article}

}

@article{Rosales2022,

title = {Cancer Mortality in People Receiving Dialysis for Kidney Failure: An Australian and New Zealand Cohort Study, 1980-2013},

author = {Brenda M. Rosales and Nicole De La Mata and Claire M. Vajdic and Patrick J. Kelly and Kate Wyburn and Angela C. Webster},

doi = {10.1053/j.ajkd.2022.03.010},

issn = {0272-6386},

year  = {2022},

date = {2022-10-00},

urldate = {2022-10-00},

journal = {American Journal of Kidney Diseases},

volume = {80},

number = {4},

pages = {449--461},

publisher = {Elsevier BV},

keywords = {CELESTIAL, Nephrology},

pubstate = {published},

tppubtype = {article}

}

@article{Khou2022,

title = {Epidemiology of cardiovascular death in kidney failure: An Australian and New Zealand cohort study using data linkage},

author = {Victor Khou and Nicole L. De La Mata and Patrick J. Kelly and Philip Masson and Emma O'Lone and Rachael L. Morton and Angela C. Webster},

doi = {10.1111/nep.14020},

issn = {1440-1797},

year  = {2022},

date = {2022-05-00},

urldate = {2022-05-00},

journal = {Nephrology},

volume = {27},

number = {5},

pages = {430--440},

publisher = {Wiley},

abstract = {<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Cardiovascular mortality risk evolves over the lifespan of kidney failure (KF), as patients develop comorbid disease and transition between treatment modalities. Absolute cardiovascular death rates would help inform clinical practice and health‐care provision, but are not well understood across a continuum of dialysis and transplant states. We aimed to characterize cardiovascular death across the natural history of KF using a lifespan approach.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We performed a population‐based cohort study of incident patients commencing kidney replacement therapy in Australia and New Zealand. Cardiovascular deaths were identified using data linkage to national death registers. We estimated the probability of death and kidney transplant using multi‐state models, and calculated rates of graft failure and cardiovascular death across demographic factors and comorbidities.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 60 823 incident patients followed over 381 874 person‐years, 25% (8492) of deaths were from cardiovascular disease. At 15 years from treatment initiation, patients had a 15.2% probability of cardiovascular death without being transplanted, but only 2.3% probability of cardiovascular death post‐transplant. Females had a 3% lower probability of cardiovascular death at 15 years (15.3% vs. 18.6%) but 4% higher probability of non‐cardiovascular death (54.5% vs. 50.8%). Within the first year of dialysis, cardiovascular mortality peaked in the second month and showed little improvement across treatment era.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Despite improvements over time, cardiovascular death remains common in KF, particularly among the dialysis population and in the first few months of treatment. Multi‐state models can provide absolute measures of cardiovascular mortality across both dialysis and transplant states.</jats:p></jats:sec>},

keywords = {CELESTIAL, General Medicine, Nephrology},

pubstate = {published},

tppubtype = {article}

}

@article{Khou2020,

title = {Cause of death for people with end-stage kidney disease withdrawing from treatment in Australia and New Zealand},

author = {Victor Khou and Nicole L De La Mata and Rachael L Morton and Patrick J Kelly and Angela C Webster},

doi = {10.1093/ndt/gfaa105},

issn = {1460-2385},

year  = {2021},

date = {2021-07-23},

urldate = {2021-07-23},

volume = {36},

number = {8},

pages = {1527--1537},

publisher = {Oxford University Press (OUP)},

abstract = {<jats:title>Abstract</jats:title>

               <jats:sec>

                  <jats:title>Background</jats:title>

                  <jats:p>Withdrawal from renal replacement therapy is common in patients with end-stage kidney disease (ESKD), but end-of-life service planning is challenging without population-specific data. We aimed to describe mortality after treatment withdrawal in Australian and New Zealand ESKD patients and evaluate death-certified causes of death.</jats:p>

               </jats:sec>

               <jats:sec>

                  <jats:title>Methods</jats:title>

                  <jats:p>We performed a retrospective cohort study on incident patients with ESKD in Australia, 1980–2013, and New Zealand, 1988–2012, from the Australian and New Zealand Dialysis and Transplant registry. We estimated mortality rates (by age, sex, calendar year and country) and summarized withdrawal-related deaths within 12 months of treatment modality change. Certified causes of death were ascertained from data linkage with the Australian National Death Index and New Zealand Mortality Collection database.</jats:p>

               </jats:sec>

               <jats:sec>

                  <jats:title>Results</jats:title>

                  <jats:p>Of 60 823 patients with ESKD, there were 8111 treatment withdrawal deaths and 26 207 other deaths over 381 874 person-years. Withdrawal-related mortality rates were higher in females and older age groups. Rates increased between 1995 and 2013, from 1142 (95% confidence interval 1064–1226) to 2706/100 000 person-years (95% confidence interval 2498–2932), with the greatest increase in 1995–2006. A third of withdrawal deaths occurred within 12 months of treatment modality change. The national death registers reported kidney failure as the underlying cause of death in 20% of withdrawal cases, with other causes including diabetes (21%) and hypertensive disease (7%). Kidney disease was not mentioned for 18% of withdrawal patients.</jats:p>

               </jats:sec>

               <jats:sec>

                  <jats:title>Conclusions</jats:title>

                  <jats:p>Treatment withdrawal represents 24% of ESKD deaths and has more than doubled in rate since 1988. Population data may supplement, but not replace, clinical data for end-of-life kidney-related service planning.</jats:p>

               </jats:sec>},

keywords = {CELESTIAL, Nephrology, Transplantation},

pubstate = {published},

tppubtype = {article}

}