title: Predictors of longterm mortality in patients with and without systemic lupus erythematosus on maintenance dialysis: a comparative study.
abstract: OBJECTIVE
  To compare the prognosis of patients with and without systemic lupus erythematosus (SLE) on dialysis and to determine the factors that affect survival after dialysis.
  
  
  METHODS
  We used the Taiwan National Health Insurance Research Database (NHRI-NHIRD-99182) and collected data on patients who started maintenance dialysis between 2001 and 2003. Patients were followed from the initiation of dialysis until death, discontinuation of dialysis, or the end of 2008. We did a Kaplan-Meier analysis of the cohort and used multivariate Cox regression analysis to identify significant predictors of survival.
  
  
  RESULTS
  Of the 22,394 dialysis patients studied, 303 (1.35%) had SLE. Hypertension and diabetes were the 2 most common comorbidities associated with dialysis for patients with and without SLE. After adjusting for age, sex, dialysis modality, and comorbidities, we found no significant survival difference between the 2 patient groups after 8 years of followup. Multivariate analysis showed that increased mortality in the patient group without SLE (p < 0.05) was associated with older age (≥ 45 years), male sex, initial choice of hemodialysis, diabetes mellitus, heart failure, coronary artery disease, cerebrovascular disease, and malignancy. In the patient group with SLE, independent predictors of mortality (p < 0.05) were older age (≥ 65 years), male sex, and diabetes mellitus.
  
  
  CONCLUSIONS
  The longterm survival outcome was similar between patients with and without SLE who were on dialysis. The factors affecting patient mortality were not identical in these 2 groups.
authors.affiliation: Department of Nephrology, Chi-Mei Medical Center, Tainan 710, Taiwan.
authors.forename: Hung-An
authors.initials: HA
authors.lastname: Chen
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Chung-Tei
authors.initials: CT
authors.lastname: Chou
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Chien
authors.forename: Chin-Chen
authors.initials: CC
authors.lastname: Chu
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Sheu
authors.forename: Yeong-Jang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Pei-Chih
authors.initials: PC
authors.lastname: Chen
authors.forename: Chun-Hsiung
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000401:mortality* / Q000628:therapy*; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan