Johns Hopkins University, Maryland, USA.
Lupus. 2012 Oct;21(11):1208-13. doi: 10.1177/0961203312451506. Epub 2012 Jun 26.
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect almost any organ system, including the kidneys. Using a large national dataset, our goal was to compare the morbidity as measured by hospitalization and mortality rates between hemodialysis patients with end-stage renal disease (ESRD) secondary to SLE to those with ESRD due to other causes.
The risk of hospitalization was calculated by Poisson regression with clustering for repeated measures using the United States Renal Data System (USRDS) Hospitalization Analytic File in strata of pediatric and adult patients. Cox proportional hazard ratio was used to assess the mortality risk in hospitalized patients. Subjects were censored at transplantation or end of follow-up.
Adult patients with ESRD secondary to SLE were hospitalized more frequently than other adults (incidence rate ratio (IRR): 1.43, 95% confidence interval (CI): 1.15-1.77) and had a higher risk of death (hazard ratio (HR): 1.89, 95% CI: 1.66-2.5). Mortality was higher in hospitalized pediatric patients with SLE compared to pediatric patients with other causes of ESRD (HR: 2.01, 95% CI: 1.75-2.31) and adults with SLE (HR: 2.05, 95% CI: 1.79-2.34).
Our study demonstrates that there is a trend toward increased hospitalization rates in pediatric and adult patients with SLE. Among these hospitalized patients with SLE, there is an increased risk of death due to cardiovascular disease.
系统性红斑狼疮（SLE）是一种自身免疫性疾病，几乎可影响任何器官系统，包括肾脏。本研究利用大型全国性数据集，旨在比较 SLE 继发终末期肾病（ESRD）行血液透析患者与其他病因所致 ESRD 患者的住院率和死亡率。
采用美国肾脏病数据系统（USRDS）住院分析文件，以小儿和成年患者为分层，通过泊松回归对住院风险进行聚类重复测量分析。采用 Cox 比例风险比评估住院患者的死亡风险。患者在移植或随访结束时被删失。
SLE 继发 ESRD 的成年患者住院频率高于其他成年患者（发病率比（IRR）：1.43，95%置信区间（CI）：1.15-1.77），且死亡风险更高（风险比（HR）：1.89，95% CI：1.66-2.5）。与其他病因所致 ESRD 的小儿患者和 SLE 所致成人患者相比，SLE 住院小儿患者的死亡率更高（HR：2.01，95% CI：1.75-2.31）。
本研究表明 SLE 小儿和成年患者的住院率呈上升趋势。在这些 SLE 住院患者中，心血管疾病导致的死亡风险增加。
