Gabriel Horta-Baas1, Adolfo Camargo-Coronel2, Dafhne Guadalupe Miranda-Hernández3, Leslie Gabriela Gónzalez-Parra3, María Del Socorro Romero-Figueroa4, Mario Pérez-Cristóbal2. 1. Servicio de Reumatología, Hospital General Regional 220 «Gral. José Vicente Villada», Instituto Mexicano del Seguro Social, Toluca de Lerdo, Estado de México, México. Electronic address: gabho@hotmail.com. 2. Servicio de Reumatología, UMAE, Hospital de Especialidades «Dr. Bernardo Sepúlveda Gutiérrez», Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. 3. Servicio de Reumatología, UMAE, Hospital de Especialidades «Dr. Antonio Fraga Mouret», Centro Médico Nacional «La Raza», Instituto Mexicano del Seguro Social , Ciudad de México México. 4. Coordinación de Investigación en Salud, Delegación Estado de México Poniente, Instituto Mexicano del Seguro Social, Toluca de Lerdo, Estado de México México.
Abstract
INTRODUCTION: End-stage renal disease (ESRD) due to lupus nephritis (LN) occurs in 10%-30% of patients. Initially systemic lupus erythematosus (SLE) was a contraindication for kidney transplantation (KT). Today, long-term graft survival remains controversial. Our objective was to compare the survival after KT in patients with SLE or other causes of ESRD. METHODS: All SLE patients who had undergone KT in a retrospective cohort were included. Renal graft survival was compared with that of 50 controls, matched for age, sex, and year of transplantation. Survival was evaluated by the Kaplan-Meier test and the Cox proportional hazards model. RESULTS: Twenty-five subjects with SLE were included. The estimated 1-year, 2- and 5-year survival rates for patients with SLE were 92%, 66% and 66%. Renal graft survival did not differ between patients with SLE and other causes of ESRD (P=.39). The multivariate analysis showed no significant difference in graft survival between the two groups (hazard ratio, HR=1.95, 95% confidence interval [CI] 0.57-6.61, P=.28). The recurrence rate of LN was 8% and was not associated with graft loss. Acute rejection was the only variable associated with graft loss in patients with SLE (HR=16.5, 95% CI 1.94-140.1, P=.01). CONCLUSIONS: Renal graft survival in SLE patients did not differ from that reported for other causes of ESRD.
INTRODUCTION:End-stage renal disease (ESRD) due to lupus nephritis (LN) occurs in 10%-30% of patients. Initially systemic lupus erythematosus (SLE) was a contraindication for kidney transplantation (KT). Today, long-term graft survival remains controversial. Our objective was to compare the survival after KT in patients with SLE or other causes of ESRD. METHODS: All SLEpatients who had undergone KT in a retrospective cohort were included. Renal graft survival was compared with that of 50 controls, matched for age, sex, and year of transplantation. Survival was evaluated by the Kaplan-Meier test and the Cox proportional hazards model. RESULTS: Twenty-five subjects with SLE were included. The estimated 1-year, 2- and 5-year survival rates for patients with SLE were 92%, 66% and 66%. Renal graft survival did not differ between patients with SLE and other causes of ESRD (P=.39). The multivariate analysis showed no significant difference in graft survival between the two groups (hazard ratio, HR=1.95, 95% confidence interval [CI] 0.57-6.61, P=.28). The recurrence rate of LN was 8% and was not associated with graft loss. Acute rejection was the only variable associated with graft loss in patients with SLE (HR=16.5, 95% CI 1.94-140.1, P=.01). CONCLUSIONS: Renal graft survival in SLEpatients did not differ from that reported for other causes of ESRD.