title: Survival analysis in systemic lupus erythematosus patients on maintenance dialysis: a nationwide population-based study in Taiwan.
abstract: OBJECTIVE
  This study aimed to identify the risk factors for mortality and the impact of dialysis modalities on the survival in SLE patients with end-stage renal disease (ESRD).
  
  
  METHODS
  This retrospective nationwide population-based study using the National Health Insurance Research Database in Taiwan collected data from 1073 SLE ESRD patients starting maintenance dialysis between March 1997 and December 2006. A multivariate Cox regression hazard model was applied to identify factors predicting mortality in cohorts using different dialysis modalities and the impact of dialysis modalities on the survival outcome of these patients of both genders.
  
  
  RESULTS
  The major threat to SLE patients on maintenance dialysis was infections. For SLE patients undergoing regular haemodialysis (HD), age, male sex, and high or absence of daily steroid dosing were predictive of higher mortality. For those undergoing regular peritoneal dialysis (PD), age and high daily steroid dosing were the predictive factors. After adjusting confounding factors, male patients with HD had a significantly poorer outcome than the counterpart with PD or female patients with HD. There was no survival difference among female SLE patients with different dialysis modalities.
  
  
  CONCLUSIONS
  No underlying comorbidities were identified to increase the mortality of patients receiving particular dialysis modalities after correcting for age and steroid factors. There was no impact of different dialysis modalities on survival of female SLE patients. However, male SLE patients seemed susceptible to fatal events complicated by HD, which led to an inferior survival rate.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Rd. Sect. 2, Taipei 112, Taiwan.
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Chang
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Tsai-Hung
authors.initials: TH
authors.lastname: Wu
authors.forename: Chung-Hsien
authors.initials: CH
authors.lastname: Chaou
authors.forename: Kuan-Chia
authors.initials: KC
authors.lastname: Lin
authors.forename: Shou-Ming
authors.initials: SM
authors.lastname: Ou
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Chen
authors.forename: Chung-Tei
authors.initials: CT
authors.lastname: Chou
authors.forename: Chang-Youh
authors.initials: CY
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome