ESRD From Lupus Nephritis in the United States, 1995–2010

Abstract

Background and objectives While ESRD from lupus nephritis (ESLN) increased in the United States after the mid1990s and racial disparities were apparent, current trends are unknown.Design, setting, participants, & measurements Retrospective US Renal Data System data (n=1,557,117) were used to calculate standardized incidence ratios (standardized to 1995-1996) and outcomes of ESLN (n=16,649). For events occurring after initiation of RRT, follow-up ended on June 30, 2011.Results Overall ESLN rates (95% confidence intervals [95% CIs]) in 1995-1996 were 3.1 (2.9 to 3.2) cases per million per year. Rates were higher for subgroups characterized by African-American race (11.1 [95% CI, 10. Conclusions While ESLN appears to have stopped increasing in the last decade, racial disparities in outcomes persist.

All‐Cause and Cause‐Specific Mortality Trends of End‐Stage Renal Disease Due to Lupus Nephritis From 1995 to 2014

“…In this study of nearly all patients with incident ESRD due to LN in the US over the past 2 decades, we observed a 32% reduction in mortality. Our findings expanded on those in previous studies that showed no change in mortality rates from 1995 to 2006 and nonsignificant improvement from 1995 to 2010 among patients with incident LN‐associated ESRD in the US (). Similarly, we discovered a stable trend among patients with ESRD due to LN during the first 10 years (1995–2004).…”

“…As it was established by CMS for the enrollment of patients with new‐onset ESRD into Medicare, the USRDS contains data on nearly all new cases of ESRD in the US population, and these findings are highly generalizable. Furthermore, temporal mortality trend data according to race/ethnicity and cause of death in patients with ESRD due to LN are additional strengths compared with previous studies (). The accuracy of the LN‐associated ESRD diagnosis has been previously verified in this database, with a 93% PPV.…”

Severe infections in patients with lupus nephritis treated with immunosuppressants: A retrospective cohort study

“…Lupus nephritis (LN) is associated with increased risk of end‐stage renal disease (ESRD) and mortality . Hence proliferative LN is usually treated aggressively with immunosuppressive therapy, such as a combination of high dose glucocorticoids and a cytotoxic agent .…”

Incidence of End‐Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry

“…The population-based incidence of SLE-attributed ESRD has been estimated at 3-4 per million per year (2-5). Substantial disparities have been described in population incidence of SLE-attributed ESRD, by younger age (4-6), female sex (4), black race (2, 4-6), lower socioeconomic status (SES) (7, 8), reduced access to care (9), and residence in the South (4, 6).…”