Navigation Links
Most lupus nephritis patients with end-stage renal disease opt for hemodialysis therapy

Newly published research shows that more patients with end-stage renal disease (ESRD) caused by lupus nephritis choose hemodialysis as their initial kidney replacement therapy over peritoneal dialysis and preemptive kidney transplantation. Results of the study now available in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), also found that African Americans, Medicaid recipients, those without health insurance, and the unemployed had significantly reduced initiation of peritoneal dialysis.

According to ACR estimates up to 322,000 adult Americans have systemic lupus erythematosusa chronic autoimmune disease where the immune system becomes overactive and creates antibodies that attack healthy tissues and organs. When inflammation of the kidneys occurs, known as lupus nephritis, patients are at risk of ESRD. Previous studies report that as many as 60% of lupus patients develop nephritis, with roughly 20% of these cases advancing to ESRD over a 10-year period. Lupus patients with nephritis who progress to ESRD must select kidney replacement options such as hemodialysis, peritoneal dialysis, or kidney transplantation.

"Our study is the first and largest observational investigation of initial kidney replacement therapies selected by patients with lupus nephritis ESRD," said Dr. Karen Costenbader, the study's senior author and rheumatologist at the Brigham and Women's Hospital Lupus Center in Boston, Massachusetts. Using the U.S. Renal Data System (USRDS), researchers identified 11,317 patients with ESRD caused by lupus nephritis, between 1995 and 2006. The USRDS tracks information on ESRD patients in the U.S. who receive dialysis or kidney transplantation. Clinical and sociodemographic information was examined to determine the use patterns of kidney replacement therapies.

Study findings indicate that 82% of subjects initiated hemodialysis, 12% used peritoneal dialysis, while only 3% went straight to kidney transplantation without any type of dialysis. Those receiving peritoneal dialysisan at home process that allows patients to filter out toxins from the blood using a catheter that has been surgically implanted into the abdomenwere more likely to be female and White, and to have private insurance compared to Medicare or no insurance. Those patients who were employed, had higher levels of albumin and hemoglobin levels, and lower levels of creatinine in the bloodall indicators of better health statuswere also more likely to use an at home renal replacement method.

In 2011 the Centers for Medicare and Medicaid Services changed its payment policy for ESRD and now provide strong incentive for at home peritoneal dialysis. "Our findings show choice of kidney replacement therapy is closely linked to race, ethnicity, employment status and medical insurance type," concluded Dr. Costenbader. "Given the added incentives from healthcare coverage providers, knowledge of the social and demographic characteristics involved with dialysis choice provides rheumatologists with greater insight for treating lupus nephritis patients with ESRD." The authors recommend future studies compare the effectiveness of kidney replacement therapies and examine the sociodemographic variations involved in selecting the appropriate type of therapy.


Contact: Dawn Peters

Related medicine news :

1. Urine protein test might help diagnose kidney damage from lupus, UT Southwestern researchers find
2. Antibodies linked to cardiovascular disease increase in patients with active lupus
3. New Clues to Lupus Link With Heart Disease
4. Psychotherapy Can Help People With Lupus Cope
5. Sisters Helping Sisters: A New Lupus Research Study to Follow Sisters of Lupus Patients
6. Lupus Awareness Month Kicks Off at Rockefeller Center: EHE International Donates Display Window to S.L.E. Lupus Foundation for May
7. Genealogy may affect clinical differences in systemic lupus erythmatosus patients
8. Chinese systemic lupus erythematosus data reveal differences in epidemiology across continents
9. Researchers uncover biological rationale for why intensive lupus treatment works
10. Overactive Blood Platelets May Play Role in Lupus
11. Correction: Abatacept found ineffective in treatment of non-life threatening lupus
Post Your Comments:
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, a ... can give their videos a whole new perspective by using the title layers ... Film Studios. , ProSlice Levels contains over 30 Different presets to choose from. ...
(Date:6/26/2016)... , ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal ... personalized through a fitness app. The fitness app plans to fix the two major problems ... offer a one size fits all type program , They don’t eliminate all ...
(Date:6/25/2016)... ... 25, 2016 , ... Experts from the American Institutes for ... Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR ... care planning, healthcare costs and patient and family engagement. , AIR researchers will ...
(Date:6/25/2016)... Miami, FL (PRWEB) , ... June 25, 2016 , ... The temporary closing of Bruton ... Plant City Observer , brings up a new, often overlooked aspect of head lice: ... The closing for fumigation is not a common occurrence, but a necessary one in the ...
(Date:6/25/2016)... ... 25, 2016 , ... First Choice Emergency Room , the largest network ... the Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased ... location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Belgium , June 24, 2016 /PRNewswire/ ... announced the appointment of Dr. Edward Futcher ... a Non-Executive Director, effective June 23, 2016.Dr. Futcher ... and Nominations and Governance Committees.  As a non-executive ... provide independent expertise and strategic counsel to VolitionRx ...
(Date:6/23/2016)... 2016  MedSource announced today that it has ... solution of choice.  This latest decision demonstrates MedSource,s ... their clients by offering a state-of-the-art electronic data ... nowEDC as the EDC platform of choice in ... "nowEDC has long been a preferred EDC platform ...
(Date:6/23/2016)... HILLS, Calif. , June 23, 2016 Any ... the many challenges of the current process. Many of them ... because of the technical difficulties and high laboratory costs involved. ... have to offer it at such a high cost that ... afford it. Dr. Parsa Zadeh , founder ...
Breaking Medicine Technology: