Incidence of End-Stage Renal Disease among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry
Published Date:Mar 2016
Source:Arthritis Care Res (Hoboken). 68(3):357-365.
Pubmed Central ID:PMC4740266
Funding:1R24MD008077-01/MD/NIMHD NIH HHS/United States
CC999999/Intramural CDC HHS/United States
CDC-RFA-DP08-806/DP/NCCDPHP CDC HHS/United States
KL2-TR-000455/TR/NCATS NIH HHS/United States
PA03022/PHS HHS/United States
R01-AR-065493/AR/NIAMS NIH HHS/United States
R24MD008077-01/MD/NIMHD NIH HHS/United States
U01 DP005119/DP/NCCDPHP CDC HHS/United States
U01-DP-005119/DP/NCCDPHP CDC HHS/United States
UL1-TR-000454/TR/NCATS NIH HHS/United States
To estimate and identify factors associated with incidence of all-cause end-stage renal disease (ESRD) among newly diagnosed systemic lupus erythematosus (SLE) patients.
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, in 2002-2004 (median follow-up, 7.8 years). Cumulative incidence and incidence rates (ESRD treatment initiations per 1000 patient-years) were calculated, and age- and race-adjusted Poisson models were used to calculate incidence rate ratios (IRRs).
Among 344 newly diagnosed SLE patients, 29 initiated ESRD over 2603.8 years of follow-up. Incidence rates were 13.8 (95% CI, 9.4-20.3) and 3.3 (95% CI, 0.8-13.0) per 1000 patient-years among black and white patients, respectively; corresponding 5-year cumulative incidence was 6.4% and 2.5%. 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 1000 patient-years). Results suggested that patients who were black vs. white (IRR=3.9, 95% CI, 0.9-16.4) or <18 years (vs. ≥30 years) 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.
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.
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