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Poor prognosis of end-stage renal disease in systemic lupus erythematosus: a cohort of Chinese patients

Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, National Yang-Ming University, School of Medicine, Taipei, Taiwan, Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan

Hua-Chang Fang

Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, National Yang-Ming University, School of Medicine, Taipei, Taiwan

Chien-Liang Chen

Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

Yee-Hsuan Chiou

National Yang-Ming University, School of Medicine, Taipei, Taiwan, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

Kang-Ju Chou

Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, National Yang-Ming University, School of Medicine, Taipei, Taiwan, kjchou{at}isca.vghks.gov.tw

Hsiao-Min Chung

Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, National Yang-Ming University, School of Medicine, Taipei, Taiwan

We studied the clinical course of 26 systemic lupus erythematosus(SLE) patients who started regular dialysis at our hospital and whose stay exceeded a three-month duration in order to investigate the long-term prognosis in a Chinese cohort. Clinical and serological activities of lupus before and after dialysis were analysed. To compare the long-term survival rate, controls were set using 78 age-matched end-stage renal disease (ESRD) patients who did not have SLE or diabetes mellitus and entered the chronic dialysis program at a similar period with SLE dialysis patients. There was a significant decrease in clinical lupus activity after starting regular dialysis (P < 0.05); however, the serologicalactivity remained the same. The five-and ten-yearsurvivalrates were significantly lower in the SLE patients (73 and 38% in the SLE group versus 95 and 88% in the non-SLE group, P < 0.05). SLE patients had a 4.3-times higher risk of death than non-SLE patients (P < 0.05, 95% confidence interval,1.2-15.2). Also, the deceased SLE patients had persistent lower serum levels of complement 3. SLE patients with ESRD remain clinically quiescent despite persistent serological abnormalities and have a worse prognosis than other uremia patients in the Chinese population.

Key Words: dialysis • end-stage renal disease • lupus nephritis • mortality • systemic lupus erythematosus

Lupus, Vol. 12, No. 11, 827-832 (2003)
DOI: 10.1191/0961203303lu474oa


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