title: Poor prognosis of end-stage renal disease in systemic lupus erythematosus: a cohort of Chinese patients.
abstract: 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 serological activity remained the same. The five-and ten-year survival rates 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.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Po-Tsang
authors.initials: PT
authors.lastname: Lee
authors.forename: Hua-Chang
authors.initials: HC
authors.lastname: Fang
authors.forename: Chien-Liang
authors.initials: CL
authors.lastname: Chen
authors.forename: Yee-Hsuan
authors.initials: YH
authors.lastname: Chiou
authors.forename: Kang-Ju
authors.initials: KJ
authors.lastname: Chou
authors.forename: Hsiao-Min
authors.initials: HM
authors.lastname: Chung
mesh_terms: D000328:Adult; D003165:Complement System Proteins / Q000032:analysis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000401:mortality / Q000503:physiopathology; D008181:Lupus Nephritis / Q000150:complications / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D008297:Male; D011379:Prognosis; D006435:Renal Dialysis; D015996:Survival Rate
chemical_list: D003165:Complement System Proteins