Long-term outcomes in lupus patients receiving different renal replacement therapy

Abstract

Background/purpose: To compare the long-term outcomes and survival rates of patients with end stage renal disease (ESRD) caused by lupus nephritis who received three different modalities of renal replacement therapy, including hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT).

Methods: We retrospectively analyzed 94 patients with ESRD caused by lupus nephritis. Among these, 42 received HD, 12 received PD, and 40 underwent KT. The adverse events, survival data and cause of mortality were recorded.

Results: The mean age at onset of ESRD was younger in the KT group than in the HD group. Arteriovenous fistula (AVF) infection, sepsis, and AVF dysfunction were more common in the HD group than in the KT group. Peritonitis was more common in the PD group than in the HD group and KT group. Urinary tract infection was more common in the KT group than in the HD group. Cumulative survival rates were better in the KT group than in the HD or PD group.

Conclusion: The patients with ESRD caused by lupus nephritis who underwent KT had better long-term outcomes and survival rates than those who received HD or PD. This implies that KT is the better choice of renal replacement therapy in the patients with ESRD caused by lupus nephritis.

Keywords: End stage renal disease; Hemodialysis; Kidney transplantation; Peritoneal dialysis; Systemic lupus erythematosus.