Lupus Nephritis Patients with End-stage Renal Disease Benefit from Transplant

By Kaitlyn D’Onofrio - Last Updated: July 5, 2023

A recent cohort study found that lupus nephritis patients with end-stage renal disease (LN-ESRD) may significantly decrease their mortality risk by undergoing a renal transplant.

Advertisement

The study consisted of data from the United States Renal Data System on LN-ESRD patients who were put on a waitlist for a renal transplant. Primary outcomes were all-cause and cause-specific mortality. Researchers calculated hazard ratios (HRs) using time-dependent Cox regression analysis.

A total of 9,659 LN-ESRD patients were put on a renal transplant waitlist during the study period; 59% (n = 5,738) had a transplant. Waitlisted patients who underwent transplant had a lower all-cause morality risk (adjusted HR, 0.30 [95% CI, 0.27 to 0.33]). Cause-specific mortality adjusted HRs were as follows: cardiovascular disease, 0.26 (CI, 0.23 to 0.30); coronary heart disease, 0.30 (CI, 0.19 to 0.48); infection, 0.41 (CI, 0.32 to 0.52); and sepsis, 0.41 (CI, 0.31 to 0.53).

https://twitter.com/DrJackieVolk/status/1087802244911771648

One of the study’s limitations is that other factors not measured by the researchers could be impacting the results; still, they wrote, “the E-value analysis suggested robustness of the results.”

A previous study also found good outcomes for LN-ESRD patients, specifically in a Latin American cohort. Researchers evaluated data from 65 kidney transplants in LN-ESRD patients; survival at one, 10, and 15 years was 98% (P = 0.99). Graft survival rates were 92% at one year, 83% at five years, and 71% at 15 years. Two (3.1%) patients experienced recurrent disease, and one patient diagnosed with recurrent LN died from an infection. When controlling for age and sex, survival rates were still 98% after 15 years; when controlling for donor, five-year survival was 100% and 15-year survival was 98%. Graft survival rates in age- and sex- controlled analysis were 90% at one year, 84% at five years, and 64% at 15 years, and in donor-controlled analysis for the same time period were 89%, 86%, and 79%, respectively (P = 0.7718).

https://twitter.com/Lupusreference/status/1087961634352578561

Researchers for the present study wrote of their findings, “Renal transplant was associated with a survival benefit, primarily due to reduced deaths from cardiovascular disease and infection. The findings highlight the benefit of timely referral for transplant to improve outcomes in this population.”

Lupus Nephritis in End-stage Renal Disease Patients Declines

Voclosporin Add-on May Benefit Lupus Nephritis Patients

Efficacy and Safety of Mycophenolate Mofetil Versus Intravenous Pulse Cyclophosphamide as Induction Therapy in Proliferative Lupus Nephritis

Remission of proteinuria under therapeutic intervention and the renal outcomes in Japanese patients with lupus nephritis class III and IV

Source: Annals of Internal Medicine

Post Tags:SLE
Advertisement