Lupus nephritis (LN) hospitalizations disproportionately involve younger adults of Black or Hispanic race with a low income, a new national study finds.

According to the National Inpatient Sample, an all-payer national database, 333,020 hospitalizations for systemic lupus erythematosus (SLE) occurred in the United States during October 2015 through December 2017, including 8575 (2.6%) that involved an LN diagnosis. Patients with LN had a significantly younger median age at admission than other patients with SLE: 37 vs 55 years, Sonia Gupta, MD, of Creighton University in Omaha, Nebraska, and colleagues reported at the American College of Rheumatology (ACR) Convergence 2021. Unlike SLE, LN was more prevalent among men than women: 3.8% vs 2.4%. LN rates during hospitalization were significantly higher for Black (4.6%), Hispanic (4.0%), and other race patients (3.7%) compared with White patients (1.1%).

Discharge with dialysis-dependence occurred in 29% of hospitalizations with LN, Dr Gupta’s team pointed out.

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Most hospitalizations occurred at urban teaching hospitals. Patients in the lowest income quartile had the highest rate of LN (3.0%), whereas those in the highest income quartile had the lowest rate (2.1%). The cost of hospitalization in 2017 was significantly higher with than without LN: $11,200 vs $9109.

“The rate of LN and dialysis is particularly concerning given the younger age of these hospitalizations,” Dr Gupta and colleagues stated. “Further investigation is essential for identifying the structural causes that lead to these disparities and informing equitable care for patients with SLE and LN.”


Gupta S, Willer K, Begovic A, et al. Lupus nephritis disparities amongst hospitalizations in the United States: a national inpatient sample study. Presented at: ACR Convergence 2021; November 3-10, 2021. Abstract 0595.