title: Risk of end-stage renal disease in systemic lupus erythematosus patients: a nationwide population-based study.
abstract: OBJECTIVE
  The aim of this study was to estimate the risk of end-stage renal disease (ESRD) in systemic lupus erythematosus (SLE) patients.
  
  
  METHODS
  A cohort with SLE and non-SLE groups from Taiwan's longitudinal Health Insurance Database year 2000 (LHID2000) was developed. The SLE group was made up of those who were newly diagnosed with SLE in 2000. The non-SLE group with other medical illnesses was made up of those who did not have SLE from 1996 until 2008 and that were also matched 1 : 1 with the SLE group by sex, age and initial diagnosis date (index date); 1196 (1058 women and 138 men) individuals in the SLE group were included in this study.
  
  
  RESULTS
  Between 2000 and 2008, 61 (2.55%) individuals (SLE, n = 58 [4.85%]; non-SLE, n = 3 [0.25%]) had incident ESRD requiring renal replacement therapy. The incidence rates of ESRD were 612.8 and 29.3 cases per 100 000 patient-years in the SLE and non-SLE groups, respectively. The incidence of ESRD requiring renal replacement therapy occurred more frequently in male SLE (1157.0; 95% CI 502.4-1811.6) than female SLE cases (545.8; 95% CI 388.1-703.5) per 100 000 person-years (P < 0.001). During the 8-year follow-up, after adjustment for age, sex, hypertension, diabetes and hyperlipidemia, the hazard ratio (HR) for ESRD requiring renal replacement therapy was 18.2 times higher (95% CI: 5.7-58.2, P < 0.001) in the SLE group than in the non-SLE group.
  
  
  CONCLUSIONS
  ESRD is more common in SLE than non-SLE patients in this insurance database. Due to the lack of data on initial renal function and the renal parameters, the odds ratios do not represent the risk of ESRD in SLE patients compared to the general population, but only to those with non-SLE chronic illnesses.
authors: Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors: Kuang-Hui
authors: KH
authors: Yu
authors: Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.|Health Examination Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors: Chang-Fu
authors: CF
authors: Kuo
authors: Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors: I-Jun
authors: IJ
authors: Chou
authors: Biostatistics Consulting Center, Department of Public Health, Chang Gung University, Taoyuan, Taiwan.
authors: Meng-Jiun
authors: MJ
authors: Chiou
authors: Biostatistics Consulting Center, Department of Public Health, Chang Gung University, Taoyuan, Taiwan.|Biostatistics Core Laboratory, Molecular Medical Research Center, Chang Gung University, Taoyuan, Taiwan.
authors: Lai-Chu
authors: LC
authors: See
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology*; D008181:Lupus Nephritis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D017582:Renal Replacement Therapy; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: end-stage renal disease; hemodialysis; hypertension; incidence rate; risk; systemic lupus erythematosus