Levy B, Couchoud C, Rougier J-P, Jourde-Chiche N, Daugas E
Department of Nephrology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, DHU FIRE, Paris Diderot University, Paris, France.
REIN registry, Agence de la Biomédecine, Saint Denis la Plaine, France.
Lupus. 2015 Sep;24(10):1111-21. doi: 10.1177/0961203315578763. Epub 2015 Mar 25.
The objective of this article is to describe the outcome (mortality, kidney transplantation) of patients with systemic lupus erythematosus (SLE) on chronic dialysis.
The overall and cardiovascular (CV) mortality and access to kidney transplantation were studied in all SLE patients incident on chronic dialysis in France between 2002 and 2012 (REIN registry). They were compared to age- and sex-matched patients with diabetic nephropathy and with autosomal dominant polycystic kidney disease (PKD) on chronic dialysis.
A total of 368 SLE patients were included in the national REIN registry between 2002 and 2012. Cumulative incidence of death was 16.9% at five years, with no difference between haemodialysis and peritoneal dialysis. Independent risk factors of death were age, past history of cardiovascular disease (CVD) and chronic respiratory insufficiency. At five years, CV and all-cause mortality in SLE patients were lower than in matched diabetic patients, but three-fold higher than in matched PKD patients. Access to the kidney transplant waiting list and to kidney transplantation was higher in SLE patients than in matched diabetic patients, but lower than in matched PKD patients.
SLE patients on chronic dialysis are a population at high risk of death influenced by CV burden and chronic respiratory failure, but not by the method of dialysis. Their outcome, in terms of mortality and access to kidney transplantation, is intermediate between diabetic patients and patients with PKD.
本文旨在描述系统性红斑狼疮（SLE）慢性透析患者的结局（死亡率、肾移植情况）。
对2002年至2012年期间法国所有开始慢性透析的SLE患者（REIN登记处）的总体死亡率、心血管（CV）死亡率以及肾移植情况进行研究。将他们与年龄和性别匹配的慢性透析糖尿病肾病患者以及常染色体显性多囊肾病（PKD）患者进行比较。
2002年至2012年期间，全国REIN登记处共纳入368例SLE患者。五年累计死亡率为16.9%，血液透析和腹膜透析之间无差异。死亡的独立危险因素为年龄、心血管疾病（CVD）既往史和慢性呼吸功能不全。五年时，SLE患者的心血管和全因死亡率低于匹配的糖尿病患者，但比匹配的PKD患者高两倍。SLE患者进入肾移植等待名单和接受肾移植的比例高于匹配的糖尿病患者，但低于匹配的PKD患者。
慢性透析的SLE患者是受心血管负担和慢性呼吸衰竭影响的高死亡风险人群，但不受透析方式影响。他们在死亡率和肾移植方面的结局介于糖尿病患者和PKD患者之间。
