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Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Arthritis+Care+Res+(Hoboken) 2017 ; 69 (4): 599-604 Nephropedia Template TP
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Validation of Systemic Lupus Erythematosus diagnosis as the primary cause of renal failure in the United States Renal Data Systems #MMPMID27390299
Broder A; Mowrey WB; Izmirly P; Costenbader KH
Arthritis Care Res (Hoboken) 2017[Apr]; 69 (4): 599-604 PMID27390299show ga
Background: Using American College of Rheumatology (ACR) and Systemic Lupus (SLE) International Collaborating Clinics (SLICC) criteria for SLE classification as gold standards, we determined sensitivity, specificity, positive and negative predictive values (PPV and NPV) of having SLE denoted as the primary cause of end-stage renal disease (ESRD) in the United States Renal Data Systems (USRDS). Methods: ESRD patients were identified by ICD9 codes in electronic medical records of one large tertiary care center, Montefiore hospital, from 2006 to 2012. Clinical data were extracted and reviewed to establish SLE diagnosis. Data were linked by social security number, name, and date of birth to USRDS where primary causes of ESRD was ascertained. Results: Of 7396 ESRD patients at Montefiore, 97 met ACR/SLICC SLE criteria, and 86 had SLE by record only. Among the 97 SLE patients, the attributed causes of ESRD in the USRDS were as follows: 77 SLE, and 12 with other causes (unspecified glomerulonephritis, hypertension, scleroderma), and 8 missing. Sensitivity, specificity, PPV and NPV for SLE in USRDS were 79%, 99.9%, 93%, and 99.7%, respectively. Of the 60 patients with biopsy-proven lupus nephritis, 44 (73%) had SLE as primary ESRD cause in USRDS. Attribution of the primary ESRD causes among SLE patients with ACR/SLICC criteria differed by race, ethnicity, and transplant status. Conclusions: The diagnosis of SLE as the primary cause of ESRD in the USRDS has good sensitivity, and excellent specificity, PPV and NPV. Nationwide access to medical records and biopsy reports may significantly improve sensitivity of SLE diagnosis.