Abstract
Objectives: This study aimed to identify the risk factors for mortality and the impact of dialysis modalities on the survival in SLE patients with end-stage renal disease (ESRD). Methods: This retrospective nationwide population-based study using the National Health Insurance Research Database in Taiwan collected data from 1073 SLE ESRD patients starting maintenance dialysis between March 1997 and December 2006. A multivariate Cox regression hazard model was applied to identify factors predicting mortality in cohorts using different dialysis modalities and the impact of dialysis modalities on the survival outcome of these patients of both genders. Results: The major threat to SLE patients on maintenance dialysis was infections. For SLE patients undergoing regular haemodialysis (HD), age, male sex, and high or absence of daily steroid dosing were predictive of higher mortality. For those undergoing regular peritoneal dialysis (PD), age and high daily steroid dosing were the predictive factors. After adjusting confounding factors, male patients with HD had a significantly poorer outcome than the counterpart with PD or female patients with HD. There was no survival difference among female SLE patients with different dialysis modalities. Conclusion: No underlying comorbidities were identified to increase the mortality of patients receiving particular dialysis modalities after correcting for age and steroid factors. There was no impact of different dialysis modalities on survival of female SLE patients. However, male SLE patients seemed susceptible to fatal events complicated by HD, which led to an inferior survival rate.
| Original language | English |
|---|---|
| Article number | kes325 |
| Pages (from-to) | 166-172 |
| Number of pages | 7 |
| Journal | Rheumatology |
| Volume | 52 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2013 |
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Keywords
- End-stage renal disease
- Haemodialysis
- Lupus nephritis
- Peritoneal dialysis
- Systemic lupus erythematosus
ASJC Scopus subject areas
- Rheumatology
- Pharmacology (medical)
Cite this
Survival analysis in systemic lupus erythematosus patients on maintenance dialysis : A nationwide population-based study in Taiwan. / Chang, Yu Sheng; Liu, Chia Jen; Wu, Tsai Hung; Chaou, Chung Hsien; Lin, Kuan Chia; Ou, Shou Ming; Chen, Tzeng Ji; Chen, Wei Sheng; Chou, Chung Tei; Tsai, Chang Youh.
In: Rheumatology, Vol. 52, No. 1, kes325, 01.2013, p. 166-172.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival analysis in systemic lupus erythematosus patients on maintenance dialysis
T2 - A nationwide population-based study in Taiwan
AU - Chang, Yu Sheng
AU - Liu, Chia Jen
AU - Wu, Tsai Hung
AU - Chaou, Chung Hsien
AU - Lin, Kuan Chia
AU - Ou, Shou Ming
AU - Chen, Tzeng Ji
AU - Chen, Wei Sheng
AU - Chou, Chung Tei
AU - Tsai, Chang Youh
PY - 2013/1
Y1 - 2013/1
N2 - Objectives: This study aimed to identify the risk factors for mortality and the impact of dialysis modalities on the survival in SLE patients with end-stage renal disease (ESRD). Methods: This retrospective nationwide population-based study using the National Health Insurance Research Database in Taiwan collected data from 1073 SLE ESRD patients starting maintenance dialysis between March 1997 and December 2006. A multivariate Cox regression hazard model was applied to identify factors predicting mortality in cohorts using different dialysis modalities and the impact of dialysis modalities on the survival outcome of these patients of both genders. Results: The major threat to SLE patients on maintenance dialysis was infections. For SLE patients undergoing regular haemodialysis (HD), age, male sex, and high or absence of daily steroid dosing were predictive of higher mortality. For those undergoing regular peritoneal dialysis (PD), age and high daily steroid dosing were the predictive factors. After adjusting confounding factors, male patients with HD had a significantly poorer outcome than the counterpart with PD or female patients with HD. There was no survival difference among female SLE patients with different dialysis modalities. Conclusion: No underlying comorbidities were identified to increase the mortality of patients receiving particular dialysis modalities after correcting for age and steroid factors. There was no impact of different dialysis modalities on survival of female SLE patients. However, male SLE patients seemed susceptible to fatal events complicated by HD, which led to an inferior survival rate.
AB - Objectives: This study aimed to identify the risk factors for mortality and the impact of dialysis modalities on the survival in SLE patients with end-stage renal disease (ESRD). Methods: This retrospective nationwide population-based study using the National Health Insurance Research Database in Taiwan collected data from 1073 SLE ESRD patients starting maintenance dialysis between March 1997 and December 2006. A multivariate Cox regression hazard model was applied to identify factors predicting mortality in cohorts using different dialysis modalities and the impact of dialysis modalities on the survival outcome of these patients of both genders. Results: The major threat to SLE patients on maintenance dialysis was infections. For SLE patients undergoing regular haemodialysis (HD), age, male sex, and high or absence of daily steroid dosing were predictive of higher mortality. For those undergoing regular peritoneal dialysis (PD), age and high daily steroid dosing were the predictive factors. After adjusting confounding factors, male patients with HD had a significantly poorer outcome than the counterpart with PD or female patients with HD. There was no survival difference among female SLE patients with different dialysis modalities. Conclusion: No underlying comorbidities were identified to increase the mortality of patients receiving particular dialysis modalities after correcting for age and steroid factors. There was no impact of different dialysis modalities on survival of female SLE patients. However, male SLE patients seemed susceptible to fatal events complicated by HD, which led to an inferior survival rate.
KW - End-stage renal disease
KW - Haemodialysis
KW - Lupus nephritis
KW - Peritoneal dialysis
KW - Systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=84871142308&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871142308&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kes325
DO - 10.1093/rheumatology/kes325
M3 - Article
C2 - 23204553
AN - SCOPUS:84871142308
VL - 52
SP - 166
EP - 172
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 1
M1 - kes325
ER -