title: Systemic lupus erythematous and clinical outcomes in peritoneal dialysis.
abstract: BACKGROUND
  The prevalence of systemic lupus erythematous (SLE) patients requiring renal replacement therapy (RRT) is increasing but data on clinical outcomes are scarce. Interestingly, data on technique failure and peritoneal-dialysis (PD)-related infections are rarer, despite SLE patients being considered at high risk for infections. The aim of our study is to compare clinical outcomes of SLE patients on PD in a large PD cohort.
  
  
  METHODS
  We conducted a nationwide prospective observational study from the BRAZPD II cohort. For this study we identified all patients on PD for greater than 90 days. Within that subset, all those with SLE as primary renal disease were matched with PD patients without SLE for comparison of clinical outcomes, namely: patient mortality, technique survival and time to first peritonitis, then were analyzed taking into account the presence of competing risks.
  
  
  RESULTS
  Out of a total of 9907 patients, we identified 102 SLE patients incident in PD and with more than 90 days on PD. After matching the groups consisted of 92 patients with SLE and 340 matched controls. Mean age was 46.9 ± 16.8 years, 77.3% were females and 58.1% were Caucasians. After adjustments SLE sub-hazard distribution ratio for mortality was 1.06 (CI 95% 0.55-2.05), for technique failure was 1.01 (CI 95% 0.54-1.91) and for time to first peritonitis episode was 1.40 (CI 95% 0.92-2.11). The probability for occurrence of competing risks in all three outcomes was similar between groups.
  
  
  CONCLUSIONS
  PD therapy was shown to be a safe and equally successful therapy for SLE patients compared to matched non-SLE patients.
authors.affiliation: School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
authors.forename: T
authors.initials: T
authors.lastname: Proença de Moraes
authors.affiliation: School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
authors.forename: B
authors.initials: B
authors.lastname: Massignan
authors.affiliation: Graduate Program in Medicine and Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: A E
authors.initials: AE
authors.lastname: Figueiredo
authors.affiliation: School of Medicine, UNESP, Botucatu, Brazil.
authors.forename: P
authors.initials: P
authors.lastname: Barretti
authors.affiliation: School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Olandoski
authors.affiliation: Wessex Renal and Transplant Service, Queen Alexandra Hospital, Portsmouth, UK; on behalf of the BRAZPD Investigators.
authors.forename: A
authors.initials: A
authors.lastname: Kirk
authors.affiliation: School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Pecoits-Filho
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000209:etiology*; D057216:Propensity Score; D011446:Prospective Studies
keywords: BRAZPD; Lupus; mortality; peritoneal dialysis; peritonitis; technique failure