Survival analysis in systemic lupus erythematosus patients on maintenance dialysis: A nationwide population-based study in Taiwan

Yu Sheng Chang, Chia Jen Liu, Tsai Hung Wu, Chung Hsien Chaou, Kuan Chia Lin, Shou Ming Ou, Tzeng Ji Chen, Wei Sheng Chen, Chung Tei Chou, Chang Youh Tsai

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22 Citations (Scopus)

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 languageEnglish
Article numberkes325
Pages (from-to)166-172
Number of pages7
JournalRheumatology
Volume52
Issue number1
DOIs
Publication statusPublished - Jan 2013

Keywords

  • End-stage renal disease
  • Haemodialysis
  • Lupus nephritis
  • Peritoneal dialysis
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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    Chang, Y. S., Liu, C. J., Wu, T. H., Chaou, C. H., Lin, K. C., Ou, S. M., Chen, T. J., Chen, W. S., Chou, C. T., & Tsai, C. Y. (2013). Survival analysis in systemic lupus erythematosus patients on maintenance dialysis: A nationwide population-based study in Taiwan. Rheumatology, 52(1), 166-172. [kes325]. https://doi.org/10.1093/rheumatology/kes325