Long-term outcomes of end-stage kidney disease for patients with lupus nephritis

被引：47

作者：

Zhang, Lei ^{[1
,2
,3
]}

Lee, Gavin ^{[1
,2
]}

Liu, Xusheng ^{[3
]}

Pascoe, Elaine M. ^{[1
,4
]}

Badve, Sunil V. ^{[1
,2
]}

Boudville, Neil C. ^{[1
,5
]}

Clayton, Philip A. ^{[1
,6
,7
]}

Hawley, Carmel M. ^{[1
,2
]}

Kanellis, John ^{[1
,8
,9
]}

McDonald, Stephen P. ^{[1
,10
]}

Peh, Chen Au ^{[10
]}

Polkinghorne, Kevan R. ^{[1
,8
,9
,11
]}

Johnson, David W. ^{[1
,2
,4
]}

机构：

[1] Australia & New Zealand Dialysis & Transplant ANZ, Adelaide, SA, Australia

[2] Princess Alexandra Hosp, Dept Nephrol, Level 2,Ambulatory Renal & Transplant Serv Bldg, Brisbane, Qld 4102, Australia

[3] Guangdong Prov Hosp Chinese Med, Dept Nephrol, Guangzhou, Guangdong, Peoples R China

[4] Univ Queensland, Sch Med, Brisbane, Qld 4072, Australia

[5] Univ Western Australia, Sir Charles Gairdner Hosp Unit, Sch Med & Pharmacol, Perth, WA 6009, Australia

[6] Prince Wales Hosp, Dept Nephrol, Sydney, NSW, Australia

[7] Univ Sydney, Sch Publ Hlth, Sydney, NSW 2006, Australia

[8] Monash Hlth, Dept Nephrol, Melbourne, Vic, Australia

[9] Monash Univ, Dept Med, Melbourne, Vic 3004, Australia

[10] Univ Adelaide, Sch Med, Adelaide, SA, Australia

[11] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3004, Australia

来源：

KIDNEY INTERNATIONAL | 2016年 / 89卷 / 06期

关键词：

dialysis; disease recurrence; end-stage kidney disease; kidney transplantation; outcomes; renal transplantation; systemic lupus erythematosus; RENAL-TRANSPLANTATION; ERYTHEMATOSUS PATIENTS; MAINTENANCE DIALYSIS; SURVIVAL ANALYSIS; BRAZILIAN COHORT; MORTALITY; ATHEROSCLEROSIS; RECURRENCE; RECIPIENTS; BIOPSY;

D O I：

10.1016/j.kint.2016.02.014

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1337 / 1345

页数：9

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