Reduced albumin levels and utilization of arteriovenous access in pediatric patients with systemic lupus erythematosus (SLE)

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects between five and ten thousand children in the USA. Kidney disease may progress to end-stage renal disease (ESRD) and subsequent need for dialysis therapy in a significant number of children with SLE. We performed a cross-sectional analysis comparing achievement of National Kidney Foundation/Kidney Disease Outcomes Quality Initiative clinical targets in pediatric patients with SLE maintained on hemodialysis (HD) to pediatric patients with other causes of ESRD. Ninety-seven unique SLE patients and two control groups - 1,823 unique pediatric patients with other causes of ESRD and 694 pediatric patients with glomerulonephritis - were identified in the End Stage Renal Disease Clinical Performance Measures 2000-2004 Project Years. SLE patients were older, with a female and black race predominance compared with both control groups. Pediatric patients maintained on HD secondary to SLE were less likely to meet albumin targets and more likely to have vascular catheters than were pediatric patients on HD secondary to other causes. These findings may be associated with increased morbidity and mortality in pediatric patients with SLE maintained on HD and deserve further study.