Renal transplantation is associated with a significant decrease in all-cause mortality among patients with end-stage renal disease (ESRD) attributed to granulomatosis with polyangiitis (GPA), largely due to a decrease in the risk of death to cardiovascular disease (CVD), a recent study found. Therefore, prompt referral for transplantation is critical to optimize outcomes for this patient population. Researchers identified patients from the US Renal Data System with ESRD due to GPA (ESRD-GPA) between 1995 and 2014. They restricted their analysis to waitlisted subjects (n=1,525) to evaluate the impact of transplantation on mortality; 945 patients received a renal transplant. Patients were followed until death or the end of follow-up. Researchers then compared the relative risk (RR) of all-cause and cause-specific mortality in patients who received a transplant vs non-transplanted patients using a pooled logistic regression model with transplantation as a time-varying exposure. They found:

• Receiving a renal transplant was associated with a 70% reduction in the risk of all-cause mortality in multivariable-adjusted analyses.
• This was largely attributed to a 90% reduction in the risk of death due to CVD.