B Levy1, C Couchoud2, J-P Rougier3, N Jourde-Chiche4, E Daugas5. 1. Department of Nephrology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, DHU FIRE, Paris Diderot University, Paris, France. 2. REIN registry, Agence de la Biomédecine, Saint Denis la Plaine, France. 3. Department of Nephrology, Avignon Hospital, Avignon, France. 4. Aix-Marseille University, Department of Nephrology, AP-HM Hôpital Conception, INSERM UMR 1076, Vascular Research Center of Marseille, Marseille, France. 5. Department of Nephrology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, DHU FIRE, Paris Diderot University, INSERM U1149, Paris, France eric.daugas@bch.aphp.fr.
Abstract
OBJECTIVES: The objective of this article is to describe the outcome (mortality, kidney transplantation) of patients with systemic lupus erythematosus (SLE) on chronic dialysis. METHODS: The overall and cardiovascular (CV) mortality and access to kidney transplantation were studied in all SLE patients incident on chronic dialysis in France between 2002 and 2012 (REIN registry). They were compared to age- and sex-matched patients with diabetic nephropathy and with autosomal dominant polycystic kidney disease (PKD) on chronic dialysis. RESULTS: A total of 368 SLE patients were included in the national REIN registry between 2002 and 2012. Cumulative incidence of death was 16.9% at five years, with no difference between haemodialysis and peritoneal dialysis. Independent risk factors of death were age, past history of cardiovascular disease (CVD) and chronic respiratory insufficiency. At five years, CV and all-cause mortality in SLE patients were lower than in matched diabetic patients, but three-fold higher than in matched PKD patients. Access to the kidney transplant waiting list and to kidney transplantation was higher in SLE patients than in matched diabetic patients, but lower than in matched PKD patients. CONCLUSIONS: SLE patients on chronic dialysis are a population at high risk of death influenced by CV burden and chronic respiratory failure, but not by the method of dialysis. Their outcome, in terms of mortality and access to kidney transplantation, is intermediate between diabetic patients and patients with PKD.
OBJECTIVES: The objective of this article is to describe the outcome (mortality, kidney transplantation) of patients with systemic lupus erythematosus (SLE) on chronic dialysis. METHODS: The overall and cardiovascular (CV) mortality and access to kidney transplantation were studied in all SLEpatients incident on chronic dialysis in France between 2002 and 2012 (REIN registry). They were compared to age- and sex-matched patients with diabetic nephropathy and with autosomal dominant polycystic kidney disease (PKD) on chronic dialysis. RESULTS: A total of 368 SLEpatients were included in the national REIN registry between 2002 and 2012. Cumulative incidence of death was 16.9% at five years, with no difference between haemodialysis and peritoneal dialysis. Independent risk factors of death were age, past history of cardiovascular disease (CVD) and chronic respiratory insufficiency. At five years, CV and all-cause mortality in SLEpatients were lower than in matched diabeticpatients, but three-fold higher than in matched PKDpatients. Access to the kidney transplant waiting list and to kidney transplantation was higher in SLEpatients than in matched diabeticpatients, but lower than in matched PKDpatients. CONCLUSIONS:SLEpatients on chronic dialysis are a population at high risk of death influenced by CV burden and chronic respiratory failure, but not by the method of dialysis. Their outcome, in terms of mortality and access to kidney transplantation, is intermediate between diabeticpatients and patients with PKD.
Authors: Myrto Kostopoulou; Antonis Fanouriakis; Kim Cheema; John Boletis; George Bertsias; David Jayne; Dimitrios T Boumpas Journal: RMD Open Date: 2020-07