Increased risk of death in pediatric and adult patients with ESRD secondary to lupus.
Increased risk of death in pediatric and adult patients with ESRD secondary to lupus.
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继发于狼疮的 ESRD 儿童和成人患者的死亡风险增加。
DOI：
10.1007/s00467-010-1640-9
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Furth,Susan
中科院分区：
文献类型：
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作者：
Sule,Sangeeta;Fivush,Barbara;Neu,Alicia;Furth,Susan
系统性红斑狼疮（SLE）是一种多系统自身免疫性疾病，可引起严重的肾脏疾病。我们的目的是评估在血液透析（HD）的终末期肾病（ESRD）儿童和成人人群中与SLE相关的相对死亡率风险。我们根据美国肾脏数据系统（USRDS）收集的儿童和成人患者的分层数据进行Kaplan-Meier生存分析。该文件包括所有医疗保险报销的肾脏置换患者的数据。Cox比例风险模型用于评估种族和性别调整后的死亡率。受试者在移植或随访结束时被审查。继发于SLE的ESRD患儿的死亡风险是其他ESRD患儿的2倍（风险比[HR]: 2.4, 95%可信区间[CI]: 1.5-3.7）。与其他成年患者相比，SLE继发ESRD的成年患者的死亡风险也增加（HR: 1.7, 95% CI: 1.2-2.7）。儿童和成人SLE患者最常见的死亡原因是心血管疾病和心脏骤停。我们的研究表明，SLE继发ESRD的儿童和成人患者继发心血管疾病的死亡率显著增加。继发于SLE的ESRD患者可能需要积极监测动脉粥样硬化的传统危险因素，单独诊断SLE可能是ESRD患者死亡的独立危险因素。
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can cause significant kidney disease. Our goal was to assess the relative mortality risk associated with SLE in pediatric and adult populations with end-stage renal disease (ESRD) maintained on hemodialysis (HD). We performed Kaplan–Meier survival analysis from data collected by the United States Renal Data System (USRDS) in strata of pediatric and adult patients. This file includes data on all Medicare-reimbursed renal replacement patients. Cox proportional hazard models were used to assess mortality after adjusting for race and gender. Subjects were censored at transplantation or at end of follow-up. Pediatric patients with ESRD secondary to SLE had a 2-fold increased risk of death compared with other pediatric patients with ESRD (hazard ratio [HR]: 2.4, 95% confidence interval [CI]: 1.5–3.7). Adult patients with ESRD secondary to SLE were also at increased risk of death compared with other adult patients (HR: 1.7, 95% CI: 1.2–2.7). The most common causes of death in both pediatric and adult patients with SLE were cardiovascular disease and cardiac arrest. Our study demonstrates that there is a significant increase in mortality secondary to cardiovascular disease in pediatric and adult patients with ESRD secondary to SLE. Patients with ESRD secondary to SLE may need aggressive monitoring for traditional risk factors for atherosclerosis and the diagnosis of SLE alone may be an independent risk factor for death in patients with ESRD.