Anna Broder1, Wenzhu B Mowrey2, Mimi Kim2, Irina Murakhovskaya3, Henny Billett3, Joel Neugarten4, Karen H Costenbader5, Chaim Putterman6. 1. Division of Rheumatology, Department of Medicine, abroder@montefiore.org. 2. Division of Biostatistics, Department of Epidemiology and Population Health. 3. Division of Hematology. 4. Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY and. 5. Division of Rheumatology, Immunology and Allergy, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. 6. Division of Rheumatology, Department of Medicine.
Abstract
OBJECTIVE: To investigate the association between the presence of aPL and/or LA and all-cause mortality among end-stage renal disease (ESRD) patients with and without SLE. METHODS: We included ESRD patients >18 years old followed at an urban tertiary care centre between 1 January 2006 and 31 January 2014 who had aPL measured at least once after initiating haemodialysis. All SLE patients met ACR/SLICC criteria. APL/LA+ was defined as aCL IgG or IgM >40 IU, anti-β2glycoprotein1 IgG or IgM >40 IU or LA+. Deaths as at 31 January 2014 were captured in the linked National Death Index data. Time to death was defined from the first aPL measurement. RESULTS: We included 34 SLE ESRD and 64 non-SLE ESRD patients; 30 patients died during the study period. SLE ESRD patients were younger [40.4 (12.5) vs 51.9 (18.1) years, P = 0.001] and more were women (88.2% vs 54.7%, P < 0.001) vs non-SLE ESRD patients. The frequency of aPL/LA+ was 24% in SLE and 13% in non-SLE ESRD (P = 0.16). Median (inter-quartile range) follow-up time was 1.6 (0.3-3.5) years in SLE and 1.4 (0.4-3.2) years in non-SLE, P = 0.74. The adjusted hazard ratio (HR) for all-cause mortality for SLE patients who were aPL/LA+ vs aPL/LA- was 9.93 (95% CI 1.33, 74.19); the adjusted HR for non-SLE aPL/LA+ vs aPL/LA- was 0.77 (95% CI 0.14, 4.29). CONCLUSION: SLE ESRD patients with aPL/LA+ had higher all-cause mortality risk than SLE ESRD patients without these antibodies, while the effects of aPL/LA on mortality were comparable among non-SLE ESRD patients.
OBJECTIVE: To investigate the association between the presence of aPL and/or LA and all-cause mortality among end-stage renal disease (ESRD) patients with and without SLE. METHODS: We included ESRDpatients >18 years old followed at an urban tertiary care centre between 1 January 2006 and 31 January 2014 who had aPL measured at least once after initiating haemodialysis. All SLEpatients met ACR/SLICC criteria. APL/LA+ was defined as aCL IgG or IgM >40 IU, anti-β2glycoprotein1 IgG or IgM >40 IU or LA+. Deaths as at 31 January 2014 were captured in the linked National Death Index data. Time to death was defined from the first aPL measurement. RESULTS: We included 34 SLEESRD and 64 non-SLEESRDpatients; 30 patients died during the study period. SLEESRDpatients were younger [40.4 (12.5) vs 51.9 (18.1) years, P = 0.001] and more were women (88.2% vs 54.7%, P < 0.001) vs non-SLEESRDpatients. The frequency of aPL/LA+ was 24% in SLE and 13% in non-SLEESRD (P = 0.16). Median (inter-quartile range) follow-up time was 1.6 (0.3-3.5) years in SLE and 1.4 (0.4-3.2) years in non-SLE, P = 0.74. The adjusted hazard ratio (HR) for all-cause mortality for SLEpatients who were aPL/LA+ vs aPL/LA- was 9.93 (95% CI 1.33, 74.19); the adjusted HR for non-SLEaPL/LA+ vs aPL/LA- was 0.77 (95% CI 0.14, 4.29). CONCLUSION:SLEESRDpatients with aPL/LA+ had higher all-cause mortality risk than SLEESRDpatients without these antibodies, while the effects of aPL/LA on mortality were comparable among non-SLEESRDpatients.
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