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. 2011 Jan;26(1):93-8.
doi: 10.1007/s00467-010-1640-9. Epub 2010 Oct 3.

Increased risk of death in pediatric and adult patients with ESRD secondary to lupus

Sangeeta Sule  1 , Barbara Fivush, Alicia Neu, Susan Furth
Affiliations

Increased risk of death in pediatric and adult patients with ESRD secondary to lupus

Sangeeta Sule et al. Pediatr Nephrol. 2011 Jan.

Abstract

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can cause significant kidney disease. Our goal was to assess the relative mortality risk associated with SLE in pediatric and adult populations with end-stage renal disease (ESRD) maintained on hemodialysis (HD). We performed Kaplan-Meier survival analysis from data collected by the United States Renal Data System (USRDS) in strata of pediatric and adult patients. This file includes data on all Medicare-reimbursed renal replacement patients. Cox proportional hazard models were used to assess mortality after adjusting for race and gender. Subjects were censored at transplantation or at end of follow-up. Pediatric patients with ESRD secondary to SLE had a 2-fold increased risk of death compared with other pediatric patients with ESRD (hazard ratio [HR]: 2.4, 95% confidence interval [CI]: 1.5-3.7). Adult patients with ESRD secondary to SLE were also at increased risk of death compared with other adult patients (HR: 1.7, 95% CI: 1.2-2.7). The most common causes of death in both pediatric and adult patients with SLE were cardiovascular disease and cardiac arrest. Our study demonstrates that there is a significant increase in mortality secondary to cardiovascular disease in pediatric and adult patients with ESRD secondary to SLE. Patients with ESRD secondary to SLE may need aggressive monitoring for traditional risk factors for atherosclerosis and the diagnosis of SLE alone may be an independent risk factor for death in patients with ESRD.

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Figures

Fig. 1
Fig. 1
Years at risk are noted on the x-axis. Pediatric patients with end-stage renal disease (ESRD) secondary to systemic lupus erythematosus (SLE) died earlier than pediatric patients with ESRD from other causes
Fig. 2
Fig. 2
More adult patients with SLE died in follow-up than other adult patients with ESRD
Fig. 3
Fig. 3
There was no difference between the Kaplan–Meier curves of adult and pediatric patients with ESRD secondary to SLE
See this image and copyright information in PMC

References

    1. Stichweh D, Arce E, Pascual V. Update on pediatric systemic lupus erythematosus. Curr Opin Rheumatol. 2004;16:577–587. - PubMed
    1. Jimenez S, Cervera R, Font J, Ingelmo M. The epidemiology of systemic lupus erythematosus. Clin Rev Allergy Immunol. 2003;25:3–12. - PubMed
    1. Workgroup National Arthritis Data. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA, Pillemer SR, Reveille JD, Stone JH. Workgroup National Arthritis Data (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the united states. I. Arthritis Rheum. 2008;58:15–25. - PubMed
    1. Bogdanovic R, Nikolic V, Pasic S, Dimitrijevic J, Lipkovska-Markovic J, Eric-Marinkovic J, Ognjanovic M, Minic A, Stajic N. Lupus nephritis in childhood: a review of 53 patients followed at a single center. Pediatr Nephrol. 2004;19:36–44. - PubMed
    1. Elliot V, Cairns T, q, Cook HT. Evolution of lesions over 10 years in a patient with SLE: flowchart approach to the new International Society of Nephrology (ISN)/Renal Pathology Society (RPS) classification of lupus nephritis. Am J Kidney Dis. 2006;47:184–190. - PubMed

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