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2016 ; 68
(3
): 357-65
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gab.com Text
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English Wikipedia
Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus
Erythematosus Patients: The Georgia Lupus Registry
#MMPMID26239749
Plantinga L
; Lim SS
; Patzer R
; McClellan W
; Kramer M
; Klein M
; Pastan S
; Gordon C
; Helmick C
; Drenkard C
Arthritis Care Res (Hoboken)
2016[Mar]; 68
(3
): 357-65
PMID26239749
show ga
OBJECTIVE: To estimate and identify factors associated with the incidence of
all-cause end-stage renal disease (ESRD) among newly diagnosed systemic lupus
erythematosus (SLE) patients. METHODS: Data from a national registry of treated
ESRD were linked to data from a lupus registry of SLE patients who were newly
diagnosed and living in Atlanta, Georgia, 2002-2004 (median followup 7.8 years).
Cumulative incidence and incidence rates (ESRD treatment initiations per 1,000
patient-years) were calculated, and age- and race-adjusted Poisson models were
used to calculate incidence rate ratios (IRRs). RESULTS: Among 344 newly
diagnosed SLE patients, 29 initiated ESRD treatment over 2,603.8 years of
followup. Incidence rates were 13.8 (95% confidence interval [95% CI] 9.4-20.3)
among black patients and 3.3 (95% CI 0.8-13.0) among white patients, per 1,000
patient-years; corresponding 5-year cumulative incidence was 6.4% and 2.5% among
black and white patients, respectively. Lupus nephritis documented prior to 2005,
which occurred in 80% of those who progressed to ESRD, was the strongest risk
factor for incident ESRD (IRR 6.7 [95% CI 2.7-16.8]; incidence rate 27.6 per
1,000 patient-years). Results suggested that patients who were black versus white
(IRR 3.9 [95% CI 0.9-16.4]) or <18 years old (versus ?30 years old) at diagnosis
(IRR 2.1 [95% CI 0.9-5.3]) may be more likely to progress to ESRD, but incidence
did not differ by sex or other characteristics. CONCLUSION: The incidence of
all-cause ESRD among patients with a recent diagnosis of SLE is high in Georgia.
Interventions to decrease ESRD incidence among newly diagnosed SLE patients
should target young and black patients, as well as patients with lupus nephritis.