Impact of renal survival on the course and outcome of systemic lupus erythematosus patients treated with chronic peritoneal dialysis.
This longitudinal study investigated whether renal survival can affect the course and outcome of systemic lupus erythematosus (SLE) patients treated with chronic peritoneal dialysis (PD). Thirty-five SLE patients, out of 1115 end-stage renal disease (ESRD) patients treated with chronic PD, were seen between 1990 and 2007 at the Chang Gung Memorial Hospital. Patients were followed up for a mean of 38.8 +/- 22.9 months. There were no significant differences between patients with short renal survival (<3 years) and long renal survival (>3 years) for the various demographic variables such as age, sex, PD duration, immunosuppressive drug administration, or exchange system (P > 0.05). Interestingly, before PD, patients with short renal survival had lower serum complement levels than patients with long renal survival (C3, 40.2 +/- 14.4 vs 76.3 +/- 18.5 mg/dL, P < 0.001; and C4, 14.8 +/- 4.7 vs 22.4 +/- 8.1 mg/dL, P < 0.05). However, the differences in complement levels between the groups disappeared after PD (C3, 76.5 +/- 27.3 vs 84.2 +/- 27.8 mg/dL; and C4, 26.7 +/- 11.3 vs 22.6 +/- 10.8 mg/dL, both P > 0.05). Patients with short renal survival were more likely to have a high peritoneal solute transporter rate (PSTR) than their long renal survival counterparts (chi(2)-test, P = 0.02, and AUROC = 0.744 and P = 0.040); however, there were no significant differences for other variables such as cardiothoracic ratio (CTR), Kt/V, residual renal function, exit site infection, and peritonitis (P > 0.05). Finally, Kaplan-Meier analysis revealed that the two groups did not differ in patient and technical survival (P > 0.05). Therefore it was concluded that renal survival might be associated with PSTR, but not with patient and technical survival in SLE patients treated with PD.
Liang
Chih-Chia
CC
Department of Internal Medicine, Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
Huang
Chiu-Ching
CC
Wang
I-Kuan
IK
Chang
Chiz-Tzung
CT
Chen
Kuan-Hsing
KH
Weng
Cheng-Hao
CH
Lin
Ja-Liang
JL
Hung
Cheng-Chieh
CC
Yang
Chih-Wei
CW
Yen
Tzung-Hai
TH
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy*; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications*; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods*; D010710:Phosphates / Q000097:blood; D012372:ROC Curve; D012709:Serum Albumin; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D006454:Hemoglobins; D008055:Lipids; D010710:Phosphates; D012709:Serum Albumin; D003404:Creatinine; D002118:Calcium