Baseline characteristics of patients with atypical haemolytic uraemic syndrome (aHUS): The Australian cohort in a global aHUS registry

Nephrology (Carlton). 2020 Sep;25(9):683-690. doi: 10.1111/nep.13722. Epub 2020 May 31.

Abstract

Aims: To describe the baseline characteristics and treatment of Australian patients diagnosed with atypical haemolytic uraemic syndrome (aHUS) reported to the Global aHUS Registry.

Methods: Descriptive analysis of the Australian cohort with aHUS (n = 106) was undertaken for demographics, disease characteristics and prior treatment with eculizumab; comparing with the global cohort (n = 1688) for certain pre-specified disease characteristics.

Results: In Australia, almost two-thirds of patients diagnosed with aHUS were female and over 80% of patients were Caucasians, with similar proportions reported in the global cohort. Less than 6% of patients in the Australia and global cohorts were reported to have a history of autoimmune disease (4% vs 2%, respectively; P = .21) or cancer (5% vs 5%, respectively; P = .93), conditions that have been associated with secondary HUS. In the Australian cohort, 26% had received a kidney transplant and 68% of patients had received eculizumab. Kidneys were the most common organ involvement, followed by gastrointestinal tract (26%) and cardiovascular system (19%), with 35% of patients reported to have had at least two organs involved within 6 months prior to baseline visit or entry into the registry. Complement factor H was the most common pathogenic complement gene variant in the Australian patients.

Conclusion: Data from the aHUS registry confirms and defines region-specific disease characteristics among a selected group of Australian children and adults with aHUS reported to the registry. Ongoing and more inclusive data will provide further information about temporal trends and treatment outcomes, representing a unique opportunity for clinicians and researchers to further develop knowledge surrounding this rare disease.

Keywords: atypical haemolytic uraemic syndrome; complement gene mutation; eculizumab; kidney transplant; registry.

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Atypical Hemolytic Uremic Syndrome* / epidemiology
  • Atypical Hemolytic Uremic Syndrome* / genetics
  • Atypical Hemolytic Uremic Syndrome* / physiopathology
  • Atypical Hemolytic Uremic Syndrome* / therapy
  • Australia / epidemiology
  • Child
  • Complement Factor H / genetics
  • Complement Inactivating Agents / therapeutic use
  • Demography
  • Female
  • Gastrointestinal Tract / pathology
  • Humans
  • Kidney / pathology*
  • Kidney Transplantation / statistics & numerical data
  • Male
  • Mutation
  • Registries / statistics & numerical data

Substances

  • Antibodies, Monoclonal, Humanized
  • CFH protein, human
  • Complement Inactivating Agents
  • Complement Factor H
  • eculizumab