Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Most lupus nephritis patients with end-stage renal disease opt for hemodialysis therapy

07.11.2011
Peritoneal dialysis and kidney transplantations lower among African-Americans, uninsured, and unemployed

Newly published research shows that more patients with end-stage renal disease (ESRD) caused by lupus nephritis choose hemodialysis as their initial kidney replacement therapy over peritoneal dialysis and preemptive kidney transplantation.

Results of the study now available in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), also found that African Americans, Medicaid recipients, those without health insurance, and the unemployed had significantly reduced initiation of peritoneal dialysis.

According to ACR estimates up to 322,000 adult Americans have systemic lupus erythematosus—a chronic autoimmune disease where the immune system becomes overactive and creates antibodies that attack healthy tissues and organs. When inflammation of the kidneys occurs, known as lupus nephritis, patients are at risk of ESRD. Previous studies report that as many as 60% of lupus patients develop nephritis, with roughly 20% of these cases advancing to ESRD over a 10-year period. Lupus patients with nephritis who progress to ESRD must select kidney replacement options such as hemodialysis, peritoneal dialysis, or kidney transplantation.

"Our study is the first and largest observational investigation of initial kidney replacement therapies selected by patients with lupus nephritis ESRD," said Dr. Karen Costenbader, the study's senior author and rheumatologist at the Brigham and Women's Hospital Lupus Center in Boston, Massachusetts. Using the U.S. Renal Data System (USRDS), researchers identified 11,317 patients with ESRD caused by lupus nephritis, between 1995 and 2006. The USRDS tracks information on ESRD patients in the U.S. who receive dialysis or kidney transplantation. Clinical and sociodemographic information was examined to determine the use patterns of kidney replacement therapies.

Study findings indicate that 82% of subjects initiated hemodialysis, 12% used peritoneal dialysis, while only 3% went straight to kidney transplantation without any type of dialysis. Those receiving peritoneal dialysis—an at home process that allows patients to filter out toxins from the blood using a catheter that has been surgically implanted into the abdomen—were more likely to be female and White, and to have private insurance compared to Medicare or no insurance. Those patients who were employed, had higher levels of albumin and hemoglobin levels, and lower levels of creatinine in the blood—all indicators of better health status—were also more likely to use an at home renal replacement method.

In 2011 the Centers for Medicare and Medicaid Services changed its payment policy for ESRD and now provide strong incentive for at home peritoneal dialysis. "Our findings show choice of kidney replacement therapy is closely linked to race, ethnicity, employment status and medical insurance type," concluded Dr. Costenbader. "Given the added incentives from healthcare coverage providers, knowledge of the social and demographic characteristics involved with dialysis choice provides rheumatologists with greater insight for treating lupus nephritis patients with ESRD." The authors recommend future studies compare the effectiveness of kidney replacement therapies and examine the sociodemographic variations involved in selecting the appropriate type of therapy.

This study is published in Arthritis Care & Research. Media wishing to receive a PDF of this article may contact healthnews@wiley.com.

Full citation: "Variation in Initial Kidney Replacement Therapy for End-Stage Renal Disease Due to LN in the U.S." Amy Devlin, Sushrut Waikar, Daniel H. Solomon, Bing Lu, Tamara Shakevich, Graciela S. Alarcón, Wolfgang C. Winkelmayer, and Karen H. Costenbader. Arthritis Care and Research; Published Online: November 7, 2011 (DOI: 10.1002/acr.20607). http://doi.wiley.com/10.1002/acr.20607.

Author Contact: Media wishing to speak with Dr. Costenbader may contact Lori Shanks with Brigham and Women's Hospital at ljshanks@partners.org or at 617-534-1604.

About the Journal

Arthritis Care & Research is an official journal of the American College of Rheumatology (ACR), and the Association of Rheumatology Health Professionals (ARHP), a division of the College. Arthritis Care & Research is a peer-reviewed research publication that publishes both original research and review articles that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with arthritis and related disorders, major topics are evidence-based practice studies, clinical problems, practice guidelines, health care economics, health care policy, educational, social, and public health issues, and future trends in rheumatology practice. For details, please visit Arthritis Care & Research.

About Wiley-Blackwell

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

Media Advisory

ACR Annual Meeting Press Registration Now Open

Press registration is now open to journalists planning to attend the 2011 ACR/ARHP Annual Scientific Meeting in Chicago. Held November 4-9, the ACR/ARHP Annual Scientific Meeting is the premier meeting in rheumatology.

For more information, including to view the press conference schedule, visit www.rheumatology.org/education/annual/newsroom.asp. Follow the meeting on twitter by using the official hashtag: #ACR2011.

Dawn Peters | EurekAlert!
Further information:
http://www.wiley.com

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Transport of molecular motors into cilia

28.03.2017 | Life Sciences

A novel hybrid UAV that may change the way people operate drones

28.03.2017 | Information Technology

NASA spacecraft investigate clues in radiation belts

28.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>