title: Comparison of clinical outcomes by different renal replacement therapy in patients with end-stage renal disease secondary to lupus nephritis.
abstract: OBJECTIVE
  Many studies have compared patients with systemic lupus erythematosus (SLE) on renal replacement therapy (RRT) with non-lupus patients. However, few data are available on the long-term outcome of patients with end-stage renal disease (ESRD) secondary to SLE who are managed by different types of RRTs.
  
  
  METHODS
  We conducted a retrospective multicenter study on 59 patients with ESRD who underwent maintenance RRT between 1990 and 2007 for SLE. Of these patients, 28 underwent hemodialysis (HD), 14 underwent peritoneal dialysis (PD), and 17 patients received kidney transplantation (KT). We analyzed the clinical outcomes in these patients to determine the best treatment modality.
  
  
  RESULTS
  The mean follow-up period was 5 ± 3 years in the HD group, 5 ± 3 years in the PD group, and 10 ± 5 years in the KT group (p = 0.005). Disease flare-up was more common in the HD group than in the KT group (p = 0.012). Infection was more common in the PD and HD groups than in the KT group (HD vs. KT, p = 0.027; PD vs. KT, p = 0.033). Cardiovascular complications were more common in the HD group than in the other groups (p = 0.049). Orthopedic complications were more common in the PD group than in the other groups (p = 0.028). Bleeding was more common in the HD group than in the other groups (p = 0.026). Patient survival was greater in the KT group than in the HD group (p = 0.029). Technique survival was lower in the PD group than in the HD group (p = 0.019).
  
  
  CONCLUSIONS
  Among patients with ESRD secondary to SLE, KT had better patient survival and lower complication rates than HD and lower complication rates than PD. The prognosis between the HD and PD groups was similar. We conclude that if KT is not a viable treatment option, any alternative treatment should take into account the patient's general condition and preference.
authors: Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors: Seok-Hui
authors: SH
authors: Kang
authors: Byung-Ha
authors: BH
authors: Chung
authors: Sun-Ryoung
authors: SR
authors: Choi
authors: Ja-Young
authors: JY
authors: Lee
authors: Hoon-Suk
authors: HS
authors: Park
authors: In-O
authors: IO
authors: Sun
authors: Bum-Soon
authors: BS
authors: Choi
authors: Cheol-Whee
authors: CW
authors: Park
authors: Yong-Soo
authors: YS
authors: Kim
authors: Chul-Woo
authors: CW
authors: Yang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008181:Lupus Nephritis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D016896:Treatment Outcome