EFFECT OF SEVERE CYCLONE ON INCIDENCE OF GLOMERULAR DISEASE IN CENTRAL QUEENSLAND OF AUSTRALIA

T PHAM1, M ALJISHI1, J CHAN1, T HAN1,3, M MCGRAIL3, J BORG1, J MOORE1, D RANGANATHAN2,4, Z THET1,3,4

1Department of Nephrology, Central Queensland Hospital & Health Service, Rockhampton , Australia, 2Department of Nephrology, Royal Brisbane and Women’s Hospital, Brisbane, Australia, 3The University of Queensland, Rural Clinical School, Rockhampton, Australia, 4The Griffith University, Brisbane/Gold Coast, Australia

Aim: To determine the effect of a severe cyclone on incidence of glomerular disease (GD) in Central Queensland, Australia.
Background: There is a growing body of evidence that incidence of GD is increased by environmental pollution. To date, no studies have investigated any correlation between severe cyclone and the incidence of GD.
Methods: This was a retrospective observational single region study of all GD 3 years pre- and post-cyclone Marcia which occurred on 20th February 2015. Exclusion criteria were GD due to hepatitis B or C virus, HIV-associated nephropathy, plasma cell dyscrasias, and paraneoplastic glomerulopathy.
Results: There was an increased rate of anti-neutrophil cytoplasmic antibodies (ANCA) associated renal vasculitis (AAV) following Cyclone Marcia (pre-cyclone: 1 case, 1.5 cases per million person years (95% confidence interval (CI): 1.5 to 4.5)) to post-cyclone: 10 cases, 15.1 cases per million person years (95% CI: 5.5 to 24.6) with incidence rate ratio (IRR): 10.0 (95% CI: 1.4 to 444.0), p=0.006). There was no change in incidence rate of other GD diseases such as IgA nephropathy (3 cases vs. 8 cases, IRR: 2.7 (95% CI: 0.6 to 15.6), p=0.15), lupus nephritis (1 case vs. 4 cases, IRR: 4.0 (95% CI: 0.4 to 197.0), p=0.22), membranoproliferative glomerular nephritis (0 cases vs. 2 cases), membranous nephropathy (3 cases vs. 7 cases, IRR: 2.3 (95% CI: 0.5 to 14.0), p=0.23) and minimal change disease (2 cases vs. 3 cases, IRR: 1.5 (95% CI: -3.7 to 21.9, p=0.69).
Conclusions: This study suggested an association between a category V cyclone and increased incidence in AAV. This association was not observed in IgA nephropathy, lupus nephritis, membranoproliferative glomerular nephritis, membranous nephropathy and minimal change disease.


Biography:
Tony Pham MD is an intern at Rockhampton Base Hospital. He has a keen interest in nephrology and research overall, publishing 7 articles in his short academic career. He is currently studying an MPH has an extensive research background, working previously as a research assistant in forensic medicine.

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