Long-Term Clinical Outcomes of Lupus Nephritis Patients Undergoing Peritoneal Dialysis: A Matched, Case-Control Study

Perit Dial Int. 2019 Nov-Dec;39(6):570-573. doi: 10.3747/pdi.2019.00041.

Abstract

The long-term clinical outcomes of peritoneal dialysis (PD) for patients with lupus nephritis (LN) have not been well researched. In the present study, we investigated the long-term prognosis of a Chinese PD cohort. This was a retrospective case-control study that included LN patients receiving PD treatment for more than 90 days from January 2006 to December 2012. Non-diabetic control patients were selected using a ratio of 1:2 for age- and gender-matching. The primary outcome was all-cause mortality. Secondary outcomes included technique failure and hospitalization rate. All patients were followed up to 31 December 2017. A total of 28 LN patients on PD (89.3% female, mean age 42.2±15.8 years) and 56 controls were included. After a median follow-up period of 53.1 months, 11 LN patients died. The cumulative 1-, 3-, and 5-year patient survival rates were 92.4%, 84.7%, and 67.6% in LN patients, and 100%, 93.5%, and 82.9% in the control group, respectively (p = 0.035). After adjusting for confounders, LN was not significantly associated with mortality (hazard ratio [HR]: 1.39, 95% confidence interval [CI]: 0.45 - 4.26); However, LN was still an independent risk factor of technique failure (HR: 2.87, 95% CI: 1.08 - 7.66). Meanwhile, the LN group had significantly higher hospitalization and infection rates. In conclusion, LN patients undergoing PD had poor patient survival and technique survival, and higher hospitalization and infection rates.

Keywords: Hospitalization; peritonitis; survival; technique survival.

MeSH terms

  • Adult
  • Case-Control Studies
  • China / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / therapy*
  • Lupus Nephritis / complications*
  • Lupus Nephritis / mortality
  • Lupus Nephritis / therapy
  • Male
  • Peritoneal Dialysis / methods*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Time Factors