Attribution of cause of end-stage renal disease among patients with systemic lupus erythematosus: the Georgia Lupus Registry.Reportar como inadecuado

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Journal Title:

Lupus Science and Medicine


Volume 3, Number 1


BMJ Publishing Group: Open Access | 2016, Pages e000132-e000132

Type of Work:

Article | Final Publisher PDF

Abstract: OBJECTIVE: Whether using provider-attributed end-stage renal disease ESRD cause of systemic lupus erythematosus SLE in national surveillance data captures the entire population of patients with SLE and ESRD remains uncertain. Our goal was to examine attributed cause of ESRD in US surveillance data among patients with SLE who have developed ESRD. METHODS: Data from a national registry of treated ESRD United States Renal Data System USRDS were linked to the population-based Georgia Lupus Registry GLR. The provider-attributed cause of ESRD was extracted from the USRDS for each validated patient with SLE in the GLR diagnosed through 2004 who initiated treatment for ESRD through 2012. The percentage of these patients with SLE whose ESRD was subsequently attributed to SLE in the USRDS was calculated, overall and by patient characteristics. RESULTS: Among 251 patients with SLE who progressed to ESRD, 78.9% had SLE as their attributed cause of ESRD. Of the remaining 53 patients, 43.4%, 18.9% and 15.6% had ESRD attributed to hypertension, diabetes mellitus type II and non-SLE-related glomerulonephritis, respectively. Attribution of ESRD to SLE was higher among patients aged ≤30 87.9-93.9% vs >30 52.6%; p<0.001 but did not differ by sex or race. Having Medicaid 86.2% or no insurance 93.5% was associated with greater attribution of ESRD to SLE than having private insurance 72.5%; p=0.02, as was having two or more providers state a diagnosis of SLE 89.0% vs 73.5% with a rheumatologist diagnosis alone; p=0.008. CONCLUSIONS: These estimates indicate that USRDS-based studies may underreport ESRD among US patients with SLE. However, observed patterns of differential attribution of ESRD cause, particularly by age, suggest that providers may be correctly attributing ESRD to causes other than SLE among some patients with SLE.

Subjects: Health Sciences, Epidemiology - Health Sciences, Medicine and Surgery - Research Funding: This research was supported by the Lupus Foundation of America.

The Georgia Lupus Registry was supported in part by the CDC, and by cooperative agreement CDC-RFA-DP08-806 and earlier by cooperative agreement PA03022 from the CDC.

This publication was supported by the Grant or Cooperative Agreement Number, DP005119, funded by the Centers for Disease Control and Prevention.

Keywords: Epidemiology - Health services research - Lupus Nephritis -

Autor: Laura Plantinga, Cristina Drenkard, Stephen Pastan, Sung Lim,



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