Navigation Links
Study finds changes in incidence of end-stage renal disease from lupus nephritis

New research documenting changes in the incidence and outcomes of end-stage renal disease (ESRD) in the U.S. between 1995 and 2006, found a significant increase in incidence rates among patients 5 to 39 years of age and in African Americans. A second related studythe largest pediatric lupus nephritis-associated ESRD study to daterevealed high rates of adverse outcomes among children with ESRD due to lupus nephritis. Despite novel therapies, outcomes have not improved in over a decade. Both studies now appear online in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

More than 300,000 Americans are diagnosed with systemic lupus erythematosus (SLE), a chronic autoimmune disease that causes widespread inflammation, extreme fatigue, joint pain, and organ damage. Approximately 15% to 20% of all cases of SLE occur among children. Medical evidence has shown that up to 60% of adults and 80% of children with SLE develop nephritisa potentially serious complication of lupus in which inflammation of the kidney could lead to renal failure. Prior studies report 10% to 30% of patients with lupus nephritis progress to ESRD within 15 years of diagnosis, despite aggressive treatment.

"Our studies examined trends in the incidence and outcomes of ESRD due to lupus nephritis for both adults and children in the U.S.," said lead study author Karen Costenbader, MD, MPH, from Brigham and Women's Hospital in Boston, Massachusetts. Researchers identified patients with lupus nephritis ESRD using data (1995-2006) from the U.S. Renal Data System, a national registry of patients who receive renal dialysis or kidney transplantation. Demographic and clinical characteristics, changes in rates of waitlisting for kidney transplant, kidney transplantation data, and all-cause mortality were examined.

The research team identified 12,344 cases of lupus nephritis ESRD with a mean age of onset of 41 years; 82% were female and 50% were African American. During the study period standardized incidence rates (SIRs) increased significantly among patients 5 to 39 years of age, African Americans, and in the U.S. Southeast. In fact, African Americans had a SIR of 6-7 times that of white patients. Researchers also noted that rates of pre-emptive kidney transplantation at ESRD onset slightly increased, but kidney transplantation rates within the first three years of ESRD declined. Rates of mortality did not change in over a decade of evaluation.

In the study specifically examining outcomes among children with lupus nephritis-associated ESRD, there were 583 cases identified and the mean age of onset was 16.2 years. Of those children with ESRD, 51% were African American, 39% were white, and 24% were Hispanic. Dr. Linda Hiraki, lead study author, with Dr. Costenbader and colleagues determined that within five years of ESRD onset 49% of children were wait-listed for kidney transplant, 33% received a kidney transplant and 22% died. The primary causes of mortality among children with ESRD were cardiopulmonary complications (31%) and infections (16%); risk of mortality in African American children was almost double that of white children.

While advances in treatment, such has preemptive kidney transplantation at ESRD onset, have been made in recent years, researchers found no improvement in outcomes. The team reported higher incidence rates in younger patients (ages 5-19 and 20-39 years), among African Americans, and in the Southern portion of the U.S. Age, race, ethnicity, insurance, and geographic region were associated with significant variation in 5-year wait-listing for kidney transplant, kidney transplantation and mortality among children with ESRD. "The changing demographics and poor survival rates highlight the ongoing challenge of caring for these patients," concluded Dr. Costenbader. "Further research is urgently needed to identify modifiable risk factors and interventions that can improve incidence rates and outcomes for children and adults with lupus nephritis ESRD."


Contact: Dawn Peters

Related medicine news :

1. Some women worry too much about breast cancer returning, U-M study finds
2. Laughter, Music May Lower Blood Pressure, Study Says
3. Study Highlights How Moms Depression, Anger Stresses Kids
4. UNC physician-scientist receives grant to study breast cancer brain metastases
5. Short Course of Hormone Therapy Boosts Prostate Cancer Survival: Study
6. Largest study of high-deductible health plans finds savings, less preventive care
7. Novel Treatment for Pancreatic Cancer Under Study
8. Weaker Bones, Cellphone Use Linked in Small Study
9. ICUROS study finds international variations in quality of life loss after fracture
10. Children With Tourette Syndrome Have Better Motor Control, Study Finds
11. Americans Exposure to Mercury From Fish Wont Harm Hearts: Study
Post Your Comments:
(Date:10/13/2017)... ... October 13, 2017 , ... Many families have long-term ... long-term care insurance companies have a waiver for care if the client has a ... when the family pays for care, is often waived, so the benefits from their ...
(Date:10/13/2017)... New York, NY (PRWEB) , ... October 13, 2017 , ... ... most influential people in business to advocate for action towards gender equality at their ... 18,000 views from around the globe, and reached a social audience of over 3 ...
(Date:10/13/2017)... Abilene, Texas (PRWEB) , ... October 13, 2017 , ... ... publication this week that explains one of the most popular and least understood books ... seems like cryptic and puzzling descriptions that have baffled scholars for centuries. Many have ...
(Date:10/13/2017)... ... 2017 , ... Coveros, a leader in agile coaching services ... by the Center for Medicare and Medicaid Services (CMS). The Enterprise Agile Transformation ... Agile methodologies in a consistent and high value manner across CMS programs. Coveros ...
(Date:10/13/2017)... ... 2017 , ... “America On The Brink”: the Christian history of the United ... the creation of published author, William Nowers. Captain Nowers and his wife, Millie, ... spent thirty years in the Navy. Following his career as a naval aviator ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... Israel and NEW YORK , Sept. 27, ... with mobile health and big data solutions, today announced that its MyDario ... Please check your local TV listings for when The Dr. Oz Show ... ... season this month. ...
(Date:9/25/2017)... Sept. 25, 2017  EpiVax, Inc., a leader ... and immune-engineering today announced the launch of EpiVax ... of personalized therapeutic cancer vaccines. EpiVax has provided ... access to enabling technologies to the new precision ... lead EpiVax Oncology as Chief Executive Officer. Gad ...
(Date:9/22/2017)... Md. , Sept. 22, 2017  As the ... Republican Senators Bill Cassidy (R-LA) and ... Information notes that the medical device industry is in ... medical device tax, the 2.3% excise tax on medical ... But they also want covered patients, increased visits and ...
Breaking Medicine Technology: