Risk of end-stage renal disease in systemic lupus erythematosus patients: a nationwide population-based study

ObjectivesThe aim of this study was to estimate the risk of end-stage renal disease (ESRD) in systemic lupus erythematosus (SLE) patients. MethodsA cohort with SLE and non-SLE groups from Taiwan's longitudinal Health Insurance Database year 2000 (LHID2000) was developed. The SLE group was made up of those who were newly diagnosed with SLE in 2000. The non-SLE group with other medical illnesses was made up of those who did not have SLE from 1996 until 2008 and that were also matched 1 : 1 with the SLE group by sex, age and initial diagnosis date (index date); 1196 (1058 women and 138 men) individuals in the SLE group were included in this study. ResultsBetween 2000 and 2008, 61 (2.55%) individuals (SLE, n = 58 [4.85%]; non-SLE, n = 3 [0.25%]) had incident ESRD requiring renal replacement therapy. The incidence rates of ESRD were 612.8 and 29.3 cases per 100 000 patient-years in the SLE and non-SLE groups, respectively. The incidence of ESRD requiring renal replacement therapy occurred more frequently in male SLE (1157.0; 95% CI 502.4-1811.6) than female SLE cases (545.8; 95% CI 388.1-703.5) per 100 000 person-years (P < 0.001). During the 8-year follow-up, after adjustment for age, sex, hypertension, diabetes and hyperlipidemia, the hazard ratio (HR) for ESRD requiring renal replacement therapy was 18.2 times higher (95% CI: 5.7-58.2, P < 0.001) in the SLE group than in the non-SLE group. ConclusionsESRD is more common in SLE than non-SLE patients in this insurance database. Due to the lack of data on initial renal function and the renal parameters, the odds ratios do not represent the risk of ESRD in SLE patients compared to the general population, but only to those with non-SLE chronic illnesses.