Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry.
Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry.
复制标题
新诊断的全身性红斑狼疮患者的终末期肾脏疾病的发生率：佐治亚狼疮注册处。
DOI：
10.1002/acr.22685
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发表时间：
2016-03
影响因子：
4.7
通讯作者：
Drenkard C
中科院分区：
文献类型：
--
作者：
Plantinga L;Lim SS;Patzer R;McClellan W;Kramer M;Klein M;Pastan S;Gordon C;Helmick C;Drenkard C
评估和确定与新诊断的系统性红斑狼疮(SLE)患者的全原因终末期肾病(ESRD)发病率相关的因素。来自治疗终末期肾病的国家登记的数据与2002-2004年间居住在佐治亚州亚特兰大的新诊断的SLE患者的狼疮登记的数据相关联(平均随访7.8年)。计算累积发病率和发病率(每1000病人年开始ESRD治疗)，并使用年龄和种族调整的泊松模型计算发病率比(IRR)。在344名新诊断的系统性红斑狼疮患者中，29人在2603.8年的随访中启动了终末期系统性红斑狼疮。黑人和白人患者的发病率分别为每1000人年13.8(95%CI，9.4~20.3)和3.3(95%CI，0.8~13.0)，相应的5年累积发病率分别为6.4%和2.5%。2005年以前记录的狼疮性肾炎，发生在80%进展为ESRD的患者中，是发生ESRD的最大危险因素(IRR=6.7，95%CI，2.7-16.8；发病率=27.6/1000病人年)。结果表明，黑人与白人(IRR=3.9，95%CI，0.9~16.4)或确诊时18岁(IRR=2.1，95%CI，0.9~5.3)的患者可能更有可能进展为终末期≥，但发病率与性别或其他特征无关。在佐治亚州，最近被诊断为系统性红斑狼疮的患者中，全因ESRD的发生率很高。减少新诊断的SLE患者中ESRD发病率的干预措施应该针对年轻和黑人患者以及狼疮性肾炎患者。
To estimate and identify factors associated with incidence of all-cause end-stage renal disease (ESRD) among newly diagnosed systemic lupus erythematosus (SLE) patients. Data from a national registry of treated ESRD were linked to data from a lupus registry of SLE patients who were newly diagnosed and living in Atlanta, Georgia, in 2002-2004 (median follow-up, 7.8 years). Cumulative incidence and incidence rates (ESRD treatment initiations per 1000 patient-years) were calculated, and age- and race-adjusted Poisson models were used to calculate incidence rate ratios (IRRs). Among 344 newly diagnosed SLE patients, 29 initiated ESRD over 2603.8 years of follow-up. Incidence rates were 13.8 (95% CI, 9.4-20.3) and 3.3 (95% CI, 0.8-13.0) per 1000 patient-years among black and white patients, respectively; corresponding 5-year cumulative incidence was 6.4% and 2.5%. Lupus nephritis documented prior to 2005, which occurred in 80% of those who progressed to ESRD, was the strongest risk factor for incident ESRD (IRR=6.7, 95% CI, 2.7-16.8; incidence rate=27.6 per 1000 patient-years). Results suggested that patients who were black vs. white (IRR=3.9, 95% CI, 0.9-16.4) or <18 years (vs. ≥30 years) at diagnosis (IRR=2.1, 95% CI, 0.9-5.3) may be more likely to progress to ESRD, but incidence did not differ by sex or other characteristics. Incidence of all-cause ESRD among patients with a recent diagnosis of SLE is high in Georgia. Interventions to decrease ESRD incidence among newly diagnosed SLE patients should target young and black patients as well as patients with lupus nephritis.