Increased risk of death in African American patients with end-stage renal disease secondary to lupus

Research output: Contribution to journalArticle

Abstract

Background Systemic lupus erythematosus (SLE) is a devastating systemic disease that can lead to end-stage renal disease (ESRD). Our goal was to assess the relative mortality risk associated with race in pediatric and adult populations with ESRD secondary to SLE maintained on hemodialysis (HD).MethodsWe identified an inception cohort of patients who were started on HD in January 1990 from data collected by the United States Renal Data System (USRDS). Kaplan-Meier survival analyses were performed in these patients using the time at risk from 1 January 1990 through 31 December 2010, the last date of the USRDS data collection period in this dataset. Cox proportional hazard models were used to assess mortality, adjusted for age at dialysis initiation. Subjects were censored at transplantation or end of follow-up.ResultsThere were 1580 patients with ESRD secondary to SLE, 252 pediatric patients (62% African American) and 1328 adults (56% African American). African American pediatric patients with ESRD secondary to SLE had a 2-fold increased risk of death compared with African American children with other causes of ESRD [hazard ratio (HR): 2.1, 95% confidence interval (CI): 1.4-2.9, P <0.01]. Increased risk of death was also seen in African American adults with ESRD secondary to SLE compared with both Caucasians with ESRD secondary to SLE (HR: 2.3, 95% CI: 1.2-4.2, P <0.01) and African American adults with ESRD secondary to other diseases (HR: 1.2, 95% CI: 1.1-1.4, P <0.01).ConclusionOur study suggests that there is a significant increased risk for mortality in African American children and adults with ESRD secondary to SLE. This suggests that African Americans with ESRD secondary to SLE need aggressive monitoring.

Original languageEnglish (US)
Pages (from-to)40-44
Number of pages5
JournalClinical Kidney Journal
Volume7
Issue number1
DOIs
StatePublished - Feb 2014

Fingerprint

African Americans
Chronic Kidney Failure
Systemic Lupus Erythematosus
Confidence Intervals
Pediatrics
Information Systems
Renal Dialysis
Mortality
Kidney
Kaplan-Meier Estimate
Survival Analysis
Proportional Hazards Models
Dialysis
Transplantation

Keywords

  • dialysis
  • mortality
  • racial disparity
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

@article{4219798c4e3e42aba34803f89be0f4e3,
title = "Increased risk of death in African American patients with end-stage renal disease secondary to lupus",
abstract = "Background Systemic lupus erythematosus (SLE) is a devastating systemic disease that can lead to end-stage renal disease (ESRD). Our goal was to assess the relative mortality risk associated with race in pediatric and adult populations with ESRD secondary to SLE maintained on hemodialysis (HD).MethodsWe identified an inception cohort of patients who were started on HD in January 1990 from data collected by the United States Renal Data System (USRDS). Kaplan-Meier survival analyses were performed in these patients using the time at risk from 1 January 1990 through 31 December 2010, the last date of the USRDS data collection period in this dataset. Cox proportional hazard models were used to assess mortality, adjusted for age at dialysis initiation. Subjects were censored at transplantation or end of follow-up.ResultsThere were 1580 patients with ESRD secondary to SLE, 252 pediatric patients (62{\%} African American) and 1328 adults (56{\%} African American). African American pediatric patients with ESRD secondary to SLE had a 2-fold increased risk of death compared with African American children with other causes of ESRD [hazard ratio (HR): 2.1, 95{\%} confidence interval (CI): 1.4-2.9, P <0.01]. Increased risk of death was also seen in African American adults with ESRD secondary to SLE compared with both Caucasians with ESRD secondary to SLE (HR: 2.3, 95{\%} CI: 1.2-4.2, P <0.01) and African American adults with ESRD secondary to other diseases (HR: 1.2, 95{\%} CI: 1.1-1.4, P <0.01).ConclusionOur study suggests that there is a significant increased risk for mortality in African American children and adults with ESRD secondary to SLE. This suggests that African Americans with ESRD secondary to SLE need aggressive monitoring.",
keywords = "dialysis, mortality, racial disparity, systemic lupus erythematosus",
author = "Sangeeta Sule and Fivush, {Barbara A} and Neu, {Alicia M} and Susan Furth",
year = "2014",
month = "2",
doi = "10.1093/ckj/sft157",
language = "English (US)",
volume = "7",
pages = "40--44",
journal = "CKJ: Clinical Kidney Journal",
issn = "2048-8505",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Increased risk of death in African American patients with end-stage renal disease secondary to lupus

AU - Sule, Sangeeta

AU - Fivush, Barbara A

AU - Neu, Alicia M

AU - Furth, Susan

PY - 2014/2

Y1 - 2014/2

N2 - Background Systemic lupus erythematosus (SLE) is a devastating systemic disease that can lead to end-stage renal disease (ESRD). Our goal was to assess the relative mortality risk associated with race in pediatric and adult populations with ESRD secondary to SLE maintained on hemodialysis (HD).MethodsWe identified an inception cohort of patients who were started on HD in January 1990 from data collected by the United States Renal Data System (USRDS). Kaplan-Meier survival analyses were performed in these patients using the time at risk from 1 January 1990 through 31 December 2010, the last date of the USRDS data collection period in this dataset. Cox proportional hazard models were used to assess mortality, adjusted for age at dialysis initiation. Subjects were censored at transplantation or end of follow-up.ResultsThere were 1580 patients with ESRD secondary to SLE, 252 pediatric patients (62% African American) and 1328 adults (56% African American). African American pediatric patients with ESRD secondary to SLE had a 2-fold increased risk of death compared with African American children with other causes of ESRD [hazard ratio (HR): 2.1, 95% confidence interval (CI): 1.4-2.9, P <0.01]. Increased risk of death was also seen in African American adults with ESRD secondary to SLE compared with both Caucasians with ESRD secondary to SLE (HR: 2.3, 95% CI: 1.2-4.2, P <0.01) and African American adults with ESRD secondary to other diseases (HR: 1.2, 95% CI: 1.1-1.4, P <0.01).ConclusionOur study suggests that there is a significant increased risk for mortality in African American children and adults with ESRD secondary to SLE. This suggests that African Americans with ESRD secondary to SLE need aggressive monitoring.

AB - Background Systemic lupus erythematosus (SLE) is a devastating systemic disease that can lead to end-stage renal disease (ESRD). Our goal was to assess the relative mortality risk associated with race in pediatric and adult populations with ESRD secondary to SLE maintained on hemodialysis (HD).MethodsWe identified an inception cohort of patients who were started on HD in January 1990 from data collected by the United States Renal Data System (USRDS). Kaplan-Meier survival analyses were performed in these patients using the time at risk from 1 January 1990 through 31 December 2010, the last date of the USRDS data collection period in this dataset. Cox proportional hazard models were used to assess mortality, adjusted for age at dialysis initiation. Subjects were censored at transplantation or end of follow-up.ResultsThere were 1580 patients with ESRD secondary to SLE, 252 pediatric patients (62% African American) and 1328 adults (56% African American). African American pediatric patients with ESRD secondary to SLE had a 2-fold increased risk of death compared with African American children with other causes of ESRD [hazard ratio (HR): 2.1, 95% confidence interval (CI): 1.4-2.9, P <0.01]. Increased risk of death was also seen in African American adults with ESRD secondary to SLE compared with both Caucasians with ESRD secondary to SLE (HR: 2.3, 95% CI: 1.2-4.2, P <0.01) and African American adults with ESRD secondary to other diseases (HR: 1.2, 95% CI: 1.1-1.4, P <0.01).ConclusionOur study suggests that there is a significant increased risk for mortality in African American children and adults with ESRD secondary to SLE. This suggests that African Americans with ESRD secondary to SLE need aggressive monitoring.

KW - dialysis

KW - mortality

KW - racial disparity

KW - systemic lupus erythematosus

UR - http://www.scopus.com/inward/record.url?scp=84893035647&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893035647&partnerID=8YFLogxK

U2 - 10.1093/ckj/sft157

DO - 10.1093/ckj/sft157

M3 - Article

C2 - 25859348

AN - SCOPUS:84893035647

VL - 7

SP - 40

EP - 44

JO - CKJ: Clinical Kidney Journal

JF - CKJ: Clinical Kidney Journal

SN - 2048-8505

IS - 1

ER -