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Jarrick, S., Lundberg, S., Welander, A., Carrero, J.-J., Höijer, J., Bottai, M. & Ludvigsson, J. F. (2019). Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study.. Journal of the American Society of Nephrology, 30(5), 866-876
Open this publication in new window or tab >>Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study.
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2019 (English)In: Journal of the American Society of Nephrology, ISSN 1046-6673, E-ISSN 1533-3450, Vol. 30, no 5, p. 866-876Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The clinical course of IgA nephropathy (IgAN) varies from asymptomatic nonprogressive to aggressive disease, with up to one in four patients manifesting ESRD within 20 years of diagnosis. Although some studies have suggested that mortality appears to be increased in IgAN, such studies lacked matched controls and did not report absolute risk.

METHODS: We conducted a population-based cohort study in Sweden, involving patients with biopsy-verified IgAN diagnosed in 1974-2011; main outcome measures were death and ESRD. Using data from three national registers, we linked 3622 patients with IgAN with 18,041 matched controls; we also conducted a sibling analysis using 2773 patients with IgAN with 6210 siblings and a spousal analysis that included 2234 pairs.

RESULTS: During a median follow-up of 13.6 years, 577 (1.1%) patients with IgAN died (10.67 per 1000 person-years) compared with 2066 deaths (0.7%) in the reference population during a median follow-up of 14.1 years (7.45 per 1000 person-years). This corresponded to a 1.53-fold increased risk and an absolute excess mortality of 3.23 per 1000 person-years (equaling one extra death per 310 person-years) and a 6-year reduction in median life expectancy. Similar increases in risk were seen in comparisons with siblings and spouses. IgAN was associated with one extra case of ESRD per 54 person-years. Mortality preceding ESRD was not significantly increased compared with controls, spouses, or siblings. Overall mortality did not differ significantly between patients with IgAN-associated ESRD and patients with ESRD from other causes.

CONCLUSIONS: Patients with IgAN have an increased mortality compared with matched controls, with one extra death per 310 person-years and a 6-year reduction in life expectancy.

Place, publisher, year, edition, pages
American Society of Nephrology, 2019
Keywords
Epidemiology and outcomes, IgA nephropathy, end-stage renal disease, mortality risk
National Category
Gastroenterology and Hepatology Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-74205 (URN)10.1681/ASN.2018101017 (DOI)000467401000011 ()30971457 (PubMedID)2-s2.0-85065508250 (Scopus ID)
Note

Funding Agency:

Research Committee of Örebro County Council 

Available from: 2019-05-14 Created: 2019-05-14 Last updated: 2019-06-19Bibliographically approved
Ludvigsson, J. F., Jarrick, S., Murray, J. A. & Emilsson, L. (2018). Celiac Disease and Risk of Henoch-Schonlein Purpura Population-based Cohort Study. Journal of Clinical Gastroenterology, 52(2), 141-145
Open this publication in new window or tab >>Celiac Disease and Risk of Henoch-Schonlein Purpura Population-based Cohort Study
2018 (English)In: Journal of Clinical Gastroenterology, ISSN 0192-0790, E-ISSN 1539-2031, Vol. 52, no 2, p. 141-145Article in journal (Refereed) Published
Abstract [en]

Background and Aims: A recent study found a 10-fold increased risk of celiac disease (CD) in individuals with Henoch-Schonlein purpura (HSP), but the confidence interval (CI) was wide.

Methods: The retrospective cohort study of all patients with CD in Sweden, diagnosed through small intestinal biopsy from 1969 to 2008 (n = 29,077). Each individual with CD was matched to up to 5 controls (n = 144,433). Data on study participants were linked to diagnostic codes for HSP in the National Patient Registry. Through Cox regression we estimated hazard ratios for CD and later HSP. Through logistic regression we calculated odds ratios for HSP preceding CD.

Results: During follow-up 19 individuals with CD and 99 controls developed HSP. This corresponded to a hazard ratio of 0.96 (95% CI, 0.59-1.56). Looking backward, we found no increased risk of earlier HSP in patients with CD (odds ratio = 1.02; 95% CI, 0.601.72).

Conclusions: In this study of more than 29,000 patients with CD, we found no increased risk of HSP before or after CD.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
Keywords
celiac, cohort, Henoch-Schonlein, pupura, vasculitis
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-64967 (URN)10.1097/MCG.0000000000000750 (DOI)000423453900009 ()27820222 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-02-12 Created: 2018-02-12 Last updated: 2018-08-30Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8754-8463

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