Long-term outcomes of end-stage kidney disease for patients with lupus nephritis

Zhang, Lei, Lee, Gavin, Liu, Xusheng, Pascoe, Elaine M., Badve, Sunil V., Boudville, Neil C., Clayton, Philip A., Hawley, Carmel M., Kanellis, John, McDonald, Stephen P., Peh, Chen Au, Polkinghorne, Kevan R. and Johnson, David W. (2016) Long-term outcomes of end-stage kidney disease for patients with lupus nephritis. Kidney International, 89 6: 1337-1345. doi:10.1016/j.kint.2016.02.014

Author Zhang, Lei
Lee, Gavin
Liu, Xusheng
Pascoe, Elaine M.
Badve, Sunil V.
Boudville, Neil C.
Clayton, Philip A.
Hawley, Carmel M.
Kanellis, John
McDonald, Stephen P.
Peh, Chen Au
Polkinghorne, Kevan R.
Johnson, David W.
Title Long-term outcomes of end-stage kidney disease for patients with lupus nephritis
Journal name Kidney International   Check publisher's open access policy
ISSN 0085-2538
Publication date 2016-06-01
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.kint.2016.02.014
Open Access Status Not Open Access
Volume 89
Issue 6
Start page 1337
End page 1345
Total pages 9
Place of publication New York, NY, United States
Publisher Elsevier
Language eng
Subject 2727 Nephrology
Abstract Patient outcomes in end-stage kidney disease (ESKD) secondary to lupus nephritis have not been well described. To help define this we compared dialysis and transplant outcomes of patients with ESKD due to lupus nephritis to all other causes. All patients diagnosed with ESKD who commenced renal replacement therapy in Australia and New Zealand (1963-2012) were included. Clinical outcomes were evaluated in both a contemporary cohort (1998-2012) and the entire 50-year cohort. Of 64,160 included patients, 744 had lupus nephritis as the primary renal disease. For the contemporary cohort of 425 patients with lupus nephritis, the 5-year dialysis patient survival rate was 69%. Of 176 contemporary patients with lupus nephritis who received their first renal allograft, the 5-year patient, overall renal allograft, and death-censored renal allograft survival rates were 95%, 88%, and 93%, respectively. Patients with lupus nephritis had worse dialysis patient survival (adjusted hazard ratio 1.33, 95% confidence interval 1.12-1.58) and renal transplant patient survival (adjusted hazard ratio 1.87, 95% confidence interval 1.18-2.98), but comparable overall renal allograft survival (adjusted hazard ratio 1.19, 95% confidence interval 0.84-1.68) and death-censored renal allograft survival (adjusted hazard ratio 1.05, 95% confidence interval 0.68-1.62) compared with ESKD controls. Similar results were found in the entire cohort and when using competing-risks analysis. Thus, the ESKD of lupus nephritis was associated with worse dialysis and transplant patient survival but comparable renal allograft survival compared with other causes of ESKD.
Keyword Dialysis
Disease recurrence
End-stage kidney disease
Kidney transplantation
Renal transplantation
Systemic lupus erythematosus
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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Sub-type: Article (original research)
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