Anna Broder1, Wenzhu B Mowrey2, Peter Izmirly3, Karen H Costenbader4. 1. Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York. 2. Albert Einstein College of Medicine, Bronx, New York. 3. New York University School of Medicine, New York. 4. Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.
Abstract
OBJECTIVE: Using American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria for systemic lupus erythematosus (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 US Renal Data System (USRDS). METHODS: ESRD patients were identified by International Classification of Diseases, Ninth Revision codes in electronic medical records of 1 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 the USRDS, where primary causes of ESRD were ascertained. RESULTS: Of 7,396 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 77 SLE and 12 with other causes (unspecified glomerulonephritis, hypertension, scleroderma), and 8 missing. Sensitivity, specificity, PPV, and NPV for SLE in the 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 the USRDS. Attribution of the primary ESRD causes among SLE patients with ACR/SLICC criteria differed by race, ethnicity, and transplant status. CONCLUSION: 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.
OBJECTIVE: Using American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria for systemic lupus erythematosus (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 US Renal Data System (USRDS). METHODS:ESRDpatients were identified by International Classification of Diseases, Ninth Revision codes in electronic medical records of 1 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 the USRDS, where primary causes of ESRD were ascertained. RESULTS: Of 7,396 ESRDpatients at Montefiore, 97 met ACR/SLICC SLE criteria, and 86 had SLE by record only. Among the 97 SLEpatients, the attributed causes of ESRD in the USRDS were 77 SLE and 12 with other causes (unspecifiedglomerulonephritis, hypertension, scleroderma), and 8 missing. Sensitivity, specificity, PPV, and NPV for SLE in the 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 the USRDS. Attribution of the primary ESRD causes among SLEpatients with ACR/SLICC criteria differed by race, ethnicity, and transplant status. CONCLUSION: 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.
Authors: S Sam Lim; A Rana Bayakly; Charles G Helmick; Caroline Gordon; Kirk A Easley; Cristina Drenkard Journal: Arthritis Rheumatol Date: 2014-02 Impact factor: 10.995
Authors: Luís Inês; Cândida Silva; Maria Galindo; Francisco J López-Longo; Georgina Terroso; Vasco C Romão; Iñigo Rúa-Figueroa; Maria J Santos; José M Pego-Reigosa; Patrícia Nero; Marcos Cerqueira; Cátia Duarte; Luís C Miranda; Miguel Bernardes; Maria J Gonçalves; Coral Mouriño-Rodriguez; Filipe Araújo; Ana Raposo; Anabela Barcelos; Maura Couto; Pedro Abreu; Teresa Otón-Sanchez; Carla Macieira; Filipa Ramos; Jaime C Branco; José A P Silva; Helena Canhão; Jaime Calvo-Alén Journal: Arthritis Care Res (Hoboken) Date: 2015-08 Impact factor: 4.794
Authors: J Bradley Layton; Susan L Hogan; Caroline E Jennette; Barbara Kenderes; Jenna Krisher; J Charles Jennette; William M McClellan Journal: Clin J Am Soc Nephrol Date: 2010-08-05 Impact factor: 8.237
Authors: E M Tan; A S Cohen; J F Fries; A T Masi; D J McShane; N F Rothfield; J G Schaller; N Talal; R J Winchester Journal: Arthritis Rheum Date: 1982-11
Authors: John G Hanly; Aidan G O'Keeffe; Li Su; Murray B Urowitz; Juanita Romero-Diaz; Caroline Gordon; Sang-Cheol Bae; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; Joan T Merrill; David A Isenberg; Anisur Rahman; Ellen M Ginzler; Paul Fortin; Dafna D Gladman; Jorge Sanchez-Guerrero; Michelle Petri; Ian N Bruce; Mary Anne Dooley; Rosalind Ramsey-Goldman; Cynthia Aranow; Graciela S Alarcón; Barri J Fessler; Kristjan Steinsson; Ola Nived; Gunnar K Sturfelt; Susan Manzi; Munther A Khamashta; Ronald F van Vollenhoven; Asad A Zoma; Manuel Ramos-Casals; Guillermo Ruiz-Irastorza; S Sam Lim; Thomas Stoll; Murat Inanc; Kenneth C Kalunian; Diane L Kamen; Peter Maddison; Christine A Peschken; Soren Jacobsen; Anca Askanase; Chris Theriault; Kara Thompson; Vernon Farewell Journal: Rheumatology (Oxford) Date: 2015-09-05 Impact factor: 7.580
Authors: Anna Broder; Wenzhu B Mowrey; Ana Valle; Mimi Kim; Candace H Feldman; Kazuki Yoshida; Karen H Costenbader Journal: Arthritis Care Res (Hoboken) Date: 2021-06-13 Impact factor: 5.178