title: Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry.
abstract: OBJECTIVE
  To estimate and identify factors associated with the incidence of all-cause end-stage renal disease (ESRD) among newly diagnosed systemic lupus erythematosus (SLE) patients.
  
  
  METHODS
  Data from a national registry of treated ESRD were linked to data from a lupus registry of SLE patients who were newly diagnosed and living in Atlanta, Georgia, 2002-2004 (median followup 7.8 years). Cumulative incidence and incidence rates (ESRD treatment initiations per 1,000 patient-years) were calculated, and age- and race-adjusted Poisson models were used to calculate incidence rate ratios (IRRs).
  
  
  RESULTS
  Among 344 newly diagnosed SLE patients, 29 initiated ESRD treatment over 2,603.8 years of followup. Incidence rates were 13.8 (95% confidence interval [95% CI] 9.4-20.3) among black patients and 3.3 (95% CI 0.8-13.0) among white patients, per 1,000 patient-years; corresponding 5-year cumulative incidence was 6.4% and 2.5% among black and white patients, respectively. Lupus nephritis documented prior to 2005, which occurred in 80% of those who progressed to ESRD, was the strongest risk factor for incident ESRD (IRR 6.7 [95% CI 2.7-16.8]; incidence rate 27.6 per 1,000 patient-years). Results suggested that patients who were black versus white (IRR 3.9 [95% CI 0.9-16.4]) or <18 years old (versus ≥30 years old) at diagnosis (IRR 2.1 [95% CI 0.9-5.3]) may be more likely to progress to ESRD, but incidence did not differ by sex or other characteristics.
  
  
  CONCLUSIONS
  The incidence of all-cause ESRD among patients with a recent diagnosis of SLE is high in Georgia. Interventions to decrease ESRD incidence among newly diagnosed SLE patients should target young and black patients, as well as patients with lupus nephritis.
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Laura
authors.initials: L
authors.lastname: Plantinga
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: S Sam
authors.initials: SS
authors.lastname: Lim
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Patzer
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: William
authors.initials: W
authors.lastname: McClellan
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Michael
authors.initials: M
authors.lastname: Kramer
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Mitchel
authors.initials: M
authors.lastname: Klein
authors.affiliation: Emory University and Emory Transplant Center, Emory Healthcare, Atlanta, Georgia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Pastan
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Gordon
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Charles
authors.initials: C
authors.lastname: Helmick
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Cristina
authors.initials: C
authors.lastname: Drenkard
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017677:Age Distribution; D000367:Age Factors; D018450:Disease Progression; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D044465:White People; D055815:Young Adult