系统性红斑狼疮患者慢性肾病死亡率的趋势：一项基于美国人群的研究（1999 - 2020年）
Trends in chronic kidney disease mortality among patients with systemic lupus erythematosus: a U.S. population-based study (1999-2020).
作者信息
Qadri Maria, Rahman Shafiq Ur, Javaid Hammad, Bhandari Kritick, Syed Rahman, Khan Ameer Afzal, Bacha Zaryab, Noor Rizwana, Filal Maryem
机构信息
Jinnah Sindh Medical University, Karachi, Pakistan.
Department of Medicine, Saidu Group of Teaching Hospital/Saidu Medical College, Swat, Pakistan.
出版信息
BMC Nephrol. 2025 Aug 14;26(1):462. doi: 10.1186/s12882-025-04394-8.
BACKGROUND
Despite advancements in treatment, chronic kidney disease (CKD) remains a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). However, a comprehensive analysis of mortality trends and demographic disparities remains limited. This study aims to evaluate mortality related to CKD among patients diagnosed with SLE, acknowledging that the specific cause of CKD (e.g., lupus nephritis vs. other etiologies) cannot be determined from available data.
METHODS
The CDC WONDER database was used to obtain mortality data for U.S. adults (≥ 25 years) due to chronic renal failure in SLE from 1999 to 2020. Crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated and stratified by gender, race, year, state, census region, urbanization, and place of death. Trends in AAMRs were evaluated using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC).
RESULTS
Between 1999 and 2020, a total of 5204 deaths were attributed to chronic renal failure in patients with SLE. The overall AAMR for CKD in SLE patients increased from 0.076 to 0.104 during this period, with a pronounced rise from 2018 to 2020 (APC: 15.06). Females exhibited higher AAMR than males (0.116 vs. 0.013). Additionally, AAMRs were highest among non-Hispanic (NH) African Americans and lowest among NH Whites (0.265 vs. 0.036). Regionally, the highest AAMRs were recorded in the West, South Carolina, and Metropolitan areas. The highest crude death rate (CDR) was observed in the 55–85 + age group.
CONCLUSIONS
Mortality from CKD among patients with SLE has risen over the past two decades, especially from 2018 to 2020. These discrepancies underscore the need for targeted healthcare strategies and legislative measures to reduce the growing mortality burden.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12882-025-04394-8.
背景
尽管治疗取得了进展，但慢性肾脏病（CKD）仍然是系统性红斑狼疮（SLE）发病和死亡的主要原因。然而，对死亡率趋势和人口统计学差异的全面分析仍然有限。本研究旨在评估确诊为SLE的患者中与CKD相关的死亡率，同时承认无法从现有数据中确定CKD的具体病因（例如，狼疮性肾炎与其他病因）。
方法
使用美国疾病控制与预防中心（CDC）的WONDER数据库获取1999年至2020年美国成年人（≥25岁）因SLE导致慢性肾衰竭的死亡率数据。计算每10万人的粗死亡率和年龄调整死亡率（AAMR），并按性别、种族、年份、州、人口普查区域、城市化程度和死亡地点进行分层。使用Joinpoint回归评估AAMR的趋势，以估计年度百分比变化（APC）和平均年度百分比变化（AAPC）。
结果
1999年至2020年期间，共有5204例死亡归因于SLE患者的慢性肾衰竭。在此期间，SLE患者中CKD的总体AAMR从0.076上升至0.104，2018年至2020年有明显上升（APC：15.06）。女性的AAMR高于男性（0.116对0.013）。此外，非西班牙裔（NH）非洲裔美国人的AAMR最高，NH白人最低（0.265对0.036）。在地区方面，西部地区、南卡罗来纳州和大都市地区的AAMR最高。在55 - 85岁及以上年龄组中观察到最高的粗死亡率（CDR）。
结论
在过去二十年中，SLE患者中CKD的死亡率有所上升，尤其是在2018年至2020年期间。这些差异凸显了制定针对性医疗策略和立法措施以减轻不断增加的死亡负担的必要性。
补充信息
在线版本包含可在10.1186/s12882 - 025 - 04394 - 8获取的补充材料。
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