title: Impact of renal survival on the course and outcome of systemic lupus erythematosus patients treated with chronic peritoneal dialysis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Kuan-Hsing
authors.initials: KH
authors.lastname: Chen
authors.forename: Cheng-Hao
authors.initials: CH
authors.lastname: Weng
authors.forename: Ja-Liang
authors.initials: JL
authors.lastname: Lin
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Hung
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
mesh_terms: 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
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006454:Hemoglobins; D008055:Lipids; D010710:Phosphates; D012709:Serum Albumin; D003404:Creatinine; D002118:Calcium