Impact of pre-transplant time on dialysis on survival in patients with lupus nephritis

Clinical Rheumatology
Eleana NtatsakiDavid A Isenberg

Abstract

Lupus nephritis (LN) is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE) often leading to end-stage renal failure (ESRF) and necessitating renal transplantation (rTp). Optimal timing of rTp in SLE patients with ESRF is uncertain and could potentially affect survival. We investigated the time spent on dialysis before rTp and survival following rTp in a cohort of SLE patients. Retrospective analysis of all adult SLE patients receiving rTp over a 40-year period (1975-2015) in two tertiary UK centres. Cox proportional hazard regression and receiver operator curves (ROC) were used to determine the risk associated with time on dialysis before rTp and other potential predictors. Forty patients (age 35 ± 11 years, 34 female, 15 Caucasian, 15 Afro-Caribbean and 10 South Asian) underwent rTp. During a median follow-up of 104 months (IQR 80,145), eight (20%) patients died and the 5-year survival was 95%. Univariate analysis identified time on dialysis prior to rTp as the only potentially modifiable risk predictor of survival with a hazard ratio of 1.013 for each additional month spent on dialysis (95% CI = 1.001-1.026, p = 0.03). ROC curves demonstrated that > 24 months on dialysis had an a...Continue Reading

References

Nov 1, 1982·Arthritis and Rheumatism·E M TanR J Winchester
Jan 14, 2004·Kidney International·Jan J WeeningUNKNOWN Renal Pathology Society Working Group on the Classification of Lupus Nephritis
Jul 21, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Madhukar ChelamcharlaAlexander S Goldfarb-Rumyantzev
Feb 29, 2008·The New England Journal of Medicine·Anisur Rahman, David A Isenberg
Apr 21, 2009·Transplantation Proceedings·L ResendeA G da Costa
Dec 2, 2011·Lupus·C S OliveiraF M Ribeiro
Dec 17, 2011·Transplantation Proceedings·A NaveedB Javaid
Jun 3, 2014·Lancet·Larissa LisnevskaiaDavid Isenberg
May 15, 2015·Expert Review of Clinical Immunology·Eleana Ntatsaki, David Isenberg
Nov 18, 2015·Seminars in Nephrology·Alberto J Sabucedo, Gabriel Contreras

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