FATHERHOOD WHILE RECEIVING DIALYSIS AND AFTER KIDNEY TRANSPLANTATION: ANALYSIS OF THE AUSTRALIAN AND NEW ZEALAND DIALYSIS AND TRANSPLANTATION (ANZDATA) REGISTRY 1970–2014

A FITZPATRICK1, A GULYANI2, P CLAYTON1,2,3, SP MCDONALD, S JESUDASON1,3

1Central and Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia; 2ANZDATA and ANZOD Registry, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, South Australia; 3School of Medicine, University of Adelaide, Adelaide, South Australia

Aim: To describe parenthood outcomes for fathers receiving renal replacement therapy (RRT).

Background: The effects of paternal uraemia, immunosuppression and comorbidity may affect offspring. Outcome data for pregnancies fathered by dialysed versus transplanted men is minimal.

Methods: Parenthood data reported to ANZDATA (1970-2014) was analysed using the Student’s t-test, chi-squared/Fisher’s exact test, and random effects linear and logistic regression.

Results: Overall, 872 men had 1248 conception events reported. Renal replacement therapy modality at conception was transplant for 925 (74%), haemodialysis for 275 (22%) and peritoneal dialysis for 48 (4%) of events. Transplanted fathers had mean±SD preconception serum creatinine of 155.9±56.6 umol/L. The parenthood data form introduced in 2001 improved data collection. After 2001, 529 parenthood events were reported. Gestational age (GA) was missing for only 2.5% and birthweight (BW) for 38.6% of reports.

The live birth rate (LBR) was 96.1% (1199 births) and similar between transplanted and dialysed men (97.9% vs. 96.2%, p=ns). The LBR for pregnancies reaching >20 weeks (where GA was known) was 99.7% for transplant fathers and 99.3% for dialysed fathers, comparable to national rates (99.3%, AIHW 2014). The mean±SD GA was 38.1±2.7 weeks, and BW 3.36±0.66kg.  Treatment modality, time post-transplant and dialysis duration had no significant association with fetal outcome. Paternal mycophenolate use (n=358 events) was not associated with abnormal foetal morphology (OR 0.43, 95%CI 0.08, 2.37), and had no effect on LBR (OR 1.35, 95%CI 0.64, 2.84), GA (0.60 weeks, 95% CI 0.34, 1.54) or BW (85.6grams, 95%CI -59.6, 230.7).

Conclusions: A large number of fatherhood events have been reported to ANZDATA, facilitated by specific parenthood forms. No difference in fetal outcomes was observed between transplanted or dialysed fathers.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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