Mortality in Lupus Patients Does Not Differ By Dialysis Type

Matched pairs of lupus patients with renal disease starting with hemodialysis or peritoneal dialysis.
Matched pairs of lupus patients with renal disease starting with hemodialysis or peritoneal dialysis.

The mortality risk among patients with end-stage renal disease (ESRD) and lupus is similar regardless of their initial dialysis modality, according to a new study.

Gabriel Contreras, MD, of the University of Miami Miller School of Medicine, and colleagues used propensity score matching to create 1,352 matched pairs of patients with ESRD patients and systemic lupus erythematosus (SLE) who started hemodialysis (HD) or peritoneal dialysis (PD). The matched pairs were mostly women (86%) with a median age of 39 years. The median follow-up period was 3 years.

The HD and PD groups had overall mortality rates of 22.5% and 21.4%, respectively, within the first 3 years of observation, a non-significant difference between the groups, investigators reported online ahead of print in the Clinical Journal of the American Society of Nephrology. The matched pairs also had similar cardiovascular-related mortality rates (9.5% in the HD group, 10.5% in the PD group) and infection-related mortality (4.4% in the HD group and 3.0% in the PD group).

Dr. Contreras' group concluded that for SLE patients with ESRD, PD should be given greater consideration when initiating renal replacement therapy.

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