The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Comparison of Clinical Outcomes by Different Renal Replacement Therapy in Patients with End-Stage Renal Disease Secondary to Lupus Nephritis

  • Kang, Seok-Hui (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Chung, Byung-Ha (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Choi, Sun-Ryoung (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Lee, Ja-Young (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Park, Hoon-Suk (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Sun, In-O (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Choi, Bum-Soon (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Park, Cheol-Whee (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Yong-Soo (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Yang, Chul-Woo (Division of Nephrology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine)
  • Published : 2011.03.01
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Abstract

Background/Aims: Many studies have compared patients with systemic lupus erythematosus (SLE) on renal replacement therapy (RRT) with non-lupus patients. However, few data are available on the long-term outcome of patients with end-stage renal disease (ESRD) secondary to SLE who are managed by different types of RRTs. Methods: We conducted a retrospective multicenter study on 59 patients with ESRD who underwent maintenance RRT between 1990 and 2007 for SLE. Of these patients, 28 underwent hemodialysis (HD), 14 underwent peritoneal dialysis (PD), and 17 patients received kidney transplantation (KT). We analyzed the clinical outcomes in these patients to determine the best treatment modality. Results: The mean follow-up period was 5 ${\pm}$ 3 years in the HD group, 5 ${\pm}$ 3 years in the PD group, and 10 ${\pm}$ 5 years in the KT group (p = 0.005). Disease flare-up was more common in the HD group than in the KT group (p = 0.012). Infection was more common in the PD and HD groups than in the KT group (HD vs. KT, p = 0.027; PD vs. KT, p = 0.033). Cardiovascular complications were more common in the HD group than in the other groups (p = 0.049). Orthopedic complications were more common in the PD group than in the other groups (p = 0.028). Bleeding was more common in the HD group than in the other groups (p = 0.026). Patient survival was greater in the KT group than in the HD group (p = 0.029). Technique survival was lower in the PD group than in the HD group (p = 0.019). Conclusions: Among patients with ESRD secondary to SLE, KT had better patient survival and lower complication rates than HD and lower complication rates than PD. The prognosis between the HD and PD groups was similar. We conclude that if KT is not a viable treatment option, any alternative treatment should take into account the patient's general condition and preference.

Keywords

References

  1. Goo YS, Park HC, Choi HY, et al. The evolution of lupus activity among patients with end-stage renal disease secondary to lupus nephritis. Yonsei Med J 2004;45:199-206. https://doi.org/10.3349/ymj.2004.45.2.199
  2. Contreras G, Roth D, Pardo V, Striker LG, Schultz DR. Lupus nephritis: a clinical review for practicing nephrologists. Clin Nephrol 2002;57:95-107. https://doi.org/10.5414/CNP57095
  3. Rietveld A, Berden JH. Renal replacement therapy in lupus nephritis. Nephrol Dial Transplant 2008;23:3056-3060. https://doi.org/10.1093/ndt/gfn429
  4. Ward MM. Outcomes of renal transplantation among patients with end-stage renal disease caused by lupus nephritis. Kidney Int 2000;57:2136-2143. https://doi.org/10.1046/j.1523-1755.2000.00065.x
  5. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.
  6. Tang H, Chelamcharla M, Baird BC, Shihab FS, Koford JK, Goldfarb-Rumyantzev AS. Factors affecting kidney-transplant outcome in recipients with lupus nephritis. Clin Transplant 2008;22:263-272.
  7. Petri M, Genovese M, Engle E, Hochberg M. Definition, incidence, and clinical description of flare in systemic lupus erythematosus. A prospective cohort study. Arthritis Rheum 1991;34:937-944. https://doi.org/10.1002/art.1780340802
  8. Farrington K, Rao R, Gilg J, Ansell D, Feest T. New adult patients starting renal replacement therapy in the UK in 2005 (chapter 3). Nephrol Dial Transplant 2007;22 Suppl 7:vii11-vii29.
  9. Iseki K, Tozawa M, Iseki C, Takishita S, Ogawa Y. Demographic trends in the Okinawa Dialysis Study (OKIDS) registry (1971-2000). Kidney Int 2002;61:668-675. https://doi.org/10.1046/j.1523-1755.2002.00147.x
  10. Chelamcharla M, Javaid B, Baird BC, Goldfarb-Rumyantzev AS. The outcome of renal transplantation among systemic lupus erythematosus patients. Nephrol Dial Transplant 2007;22:3623-3630. https://doi.org/10.1093/ndt/gfm459
  11. Siu YP, Leung KT, Tong MK, Kwan TH, Mok CC. Clinical outcomes of systemic lupus erythematosus patients undergoing continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 2005;20:2797-2802. https://doi.org/10.1093/ndt/gfi060
  12. Dong G, Panaro F, Bogetti D, et al. Standard chronic immunosuppression after kidney transplantation for systemic lupus erythematosus eliminates recurrence of disease. Clin Transplant 2005;19:56-60. https://doi.org/10.1111/j.1399-0012.2004.00297.x
  13. Cobankiat J, Vathsala A, Lu YM, Woo KT. Outcome of renal transplantation under cyclosporine immunosuppression in patients with lupus nephritis. Transplant Proc 2000;32:1826-1827. https://doi.org/10.1016/S0041-1345(00)01355-5
  14. Appel GB, Radhakrishnan J, D'Agati V. Secondary glomerular disease. In: Brenner BM, editor. Brenner and Rector's The Kidney. 8th ed. Boston: Saunders, 2008:1067-1080.
  15. Siu YP, Leung KT, Tong MK, Kwan TH, Mok CC. Clinical outcomes of systemic lupus erythematosus patients undergoing continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 2005;20:2797-2802. https://doi.org/10.1093/ndt/gfi060
  16. Boechat MI, Winters WD, Hogg RJ, Fine RN, Watkins SL. Avascular necrosis of the femoral head in children with chronic renal disease. Radiology 2001;218:411-413. https://doi.org/10.1148/radiology.218.2.r01fe03411
  17. Watanabe T, Tsuchida T, Kanda N, Tamaki K. Avascular necrosis of bone in systemic lupus erythematosus. The predictive role of precipitating autoantibodies. Scand J Rheumatol 1997;26:184-187. https://doi.org/10.3109/03009749709065679
  18. Bucci JR, Oglesby RJ, Agodoa LY, Abbott KC. Hospitalizations for total hip arthroplasty after renal transplantation in the United States. Am J Transplant 2002;2:999-1004. https://doi.org/10.1034/j.1600-6143.2002.21020.x
  19. Mojcik CF, Klippel JH. End-stage renal disease and systemic lupus erythematosus. Am J Med 1996;101:100-107. https://doi.org/10.1016/S0002-9343(96)00074-5
  20. Austin HA 3rd, Boumpas DT, Vaughan EM, Balow JE. High-risk features of lupus nephritis: importance of race and clinical and histological factors in 166 patients. Nephrol Dial Transplant 1995;10:1620-1628.
  21. Font J, Ramos-Casals M, Cervera R, et al. Cardiovascular risk factors and the long-term outcome of lupus nephritis. QJM 2001;94:19-26. https://doi.org/10.1093/qjmed/94.1.19
  22. Moroni G, Tantardini F, Gallelli B, et al. The long-term prognosis of renal transplantation in patients with lupus nephritis. Am J Kidney Dis 2005;45:903-911. https://doi.org/10.1053/j.ajkd.2005.01.038
  23. Bunnapradist S, Chung P, Peng A, et al. Outcomes of renal transplantation for recipients with lupus nephritis: analysis of the Organ Procurement and Transplantation Network database. Transplantation 2006;82:612-618.

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