title: ESRD from lupus nephritis in the United States, 1995-2010.
abstract: OBJECTIVE
  While ESRD from lupus nephritis (ESLN) increased in the United States after the mid-1990s and racial disparities were apparent, current trends are unknown.
  
  
  METHODS
  Retrospective US Renal Data System data (n=1,557,117) were used to calculate standardized incidence ratios (standardized to 1995-1996) and outcomes of ESLN (n=16,649). For events occurring after initiation of RRT, follow-up ended on June 30, 2011.
  
  
  RESULTS
  Overall ESLN rates (95% confidence intervals [95% CIs]) in 1995-1996 were 3.1 (2.9 to 3.2) cases per million per year. Rates were higher for subgroups characterized by African-American race (11.1 [95% CI, 10.3 to 11.9]); other race (4.9 [95% CI, 4.0 to 5.8]); female sex (4.9 [95% CI, 4.6 to 5.2]); and ages 20-29 years (4.9 [95% CI, 4.4 to 5.4]), 30-44 years (4.6 [95% CI, 4.2 to 5.0]), and 45-64 years (4.0 [95% CI, 3.7 to 4.4]). Standardized incidence ratios for the overall population in subsequent biennia were 1.19 (1.14 to 1.24) in 1997-1998, 1.17 (1.12 to 1.22) in 1999-2000, 1.17 (1.12 to 1.22) in 2001-2002, 1.21 (1.16 to 1.26) in 2003-2004, 1.18 (1.13 to 1.23) in 2005-2006, 1.16 (1.11 to 1.21) in 2007-2008, and 1.05 (1.01 to 1.09) in 2009-2010, respectively. During a median (interquartile range) follow-up of 4.4 (6.3) years, 42.6% of patients with ESLN died, 45.3% were listed for renal transplant, and 28.7% underwent transplantation. Patients with ESLN were more likely than matched controls to be listed for and to undergo transplantation, and mortality rates were similar. Among patients with ESLN, African Americans were less likely to undergo transplantation (adjusted hazard ratio, 0.54 [0.51 to 0.58]) and more likely to die prematurely (adjusted hazard ratio, 1.23 [1.17 to 1.30]).
  
  
  CONCLUSIONS
  While ESLN appears to have stopped increasing in the last decade, racial disparities in outcomes persist.
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Donal J
authors.initials: DJ
authors.lastname: Sexton
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Scott
authors.initials: S
authors.lastname: Reule
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, and.
authors.forename: Craig
authors.initials: C
authors.lastname: Solid
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, and.
authors.forename: Shu-Cheng
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Collins
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, Minnesota, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota rfoley@cdrg.org.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Foley
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D008181:Lupus Nephritis / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: end-stage renal disease; epidemiology and outcomes; lupus nephritis