TY - JOUR
T1 - Long-term outcomes of end-stage kidney disease for patients with lupus nephritis
AU - Zhang, Lei
AU - Lee, Gavin
AU - Liu, Xusheng
AU - Pascoe, Elaine M
AU - Badve, Sunil V
AU - Boudville, Neil C.
AU - Clayton, Philip Andrew
AU - Hawley, Carmel Mary
AU - Kanellis, John
AU - McDonald, Stephen Peter
AU - Peh, Chen Au
AU - Polkinghorne, Kevan R.
AU - Johnson, David W.
PY - 2016/6
Y1 - 2016/6
N2 - Patient outcomes in end-stage kidney disease (ESKD) secondary to lupus nephritis have not been well described. To help define this we compared dialysis and transplant outcomes of patients with ESKD due to lupus nephritis to all other causes. All patients diagnosed with ESKD who commenced renal replacement therapy in Australia and New Zealand (1963–2012) were included. Clinical outcomes were evaluated in both a contemporary cohort (1998–2012) and the entire 50-year cohort. Of 64,160 included patients, 744 had lupus nephritis as the primary renal disease. For the contemporary cohort of 425 patients with lupus nephritis, the 5-year dialysis patient survival rate was 69%. Of 176 contemporary patients with lupus nephritis who received their first renal allograft, the 5-year patient, overall renal allograft, and death-censored renal allograft survival rates were 95%, 88%, and 93%, respectively. Patients with lupus nephritis had worse dialysis patient survival (adjusted hazard ratio 1.33, 95% confidence interval 1.12–1.58) and renal transplant patient survival (adjusted hazard ratio 1.87, 95% confidence interval 1.18–2.98), but comparable overall renal allograft survival (adjusted hazard ratio 1.19, 95% confidence interval 0.84–1.68) and death-censored renal allograft survival (adjusted hazard ratio 1.05, 95% confidence interval 0.68–1.62) compared with ESKD controls. Similar results were found in the entire cohort and when using competing-risks analysis. Thus, the ESKD of lupus nephritis was associated with worse dialysis and transplant patient survival but comparable renal allograft survival compared with other causes of ESKD.
AB - Patient outcomes in end-stage kidney disease (ESKD) secondary to lupus nephritis have not been well described. To help define this we compared dialysis and transplant outcomes of patients with ESKD due to lupus nephritis to all other causes. All patients diagnosed with ESKD who commenced renal replacement therapy in Australia and New Zealand (1963–2012) were included. Clinical outcomes were evaluated in both a contemporary cohort (1998–2012) and the entire 50-year cohort. Of 64,160 included patients, 744 had lupus nephritis as the primary renal disease. For the contemporary cohort of 425 patients with lupus nephritis, the 5-year dialysis patient survival rate was 69%. Of 176 contemporary patients with lupus nephritis who received their first renal allograft, the 5-year patient, overall renal allograft, and death-censored renal allograft survival rates were 95%, 88%, and 93%, respectively. Patients with lupus nephritis had worse dialysis patient survival (adjusted hazard ratio 1.33, 95% confidence interval 1.12–1.58) and renal transplant patient survival (adjusted hazard ratio 1.87, 95% confidence interval 1.18–2.98), but comparable overall renal allograft survival (adjusted hazard ratio 1.19, 95% confidence interval 0.84–1.68) and death-censored renal allograft survival (adjusted hazard ratio 1.05, 95% confidence interval 0.68–1.62) compared with ESKD controls. Similar results were found in the entire cohort and when using competing-risks analysis. Thus, the ESKD of lupus nephritis was associated with worse dialysis and transplant patient survival but comparable renal allograft survival compared with other causes of ESKD.
KW - dialysis
KW - disease recurrence
KW - end-stage kidney disease
KW - kidney transplantation
KW - outcomes
KW - renal transplantation
KW - systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=84978066646&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2016.02.014
DO - 10.1016/j.kint.2016.02.014
M3 - Article
AN - SCOPUS:84978066646
SN - 0085-2538
VL - 89
SP - 1337
EP - 1345
JO - Kidney International
JF - Kidney International
IS - 6
ER -