Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study finds changes in incidence of end-stage renal disease from lupus nephritis

28.03.2011
Disease rates rise in children and African Americans; no outcome improvement in over a decade

New research documenting changes in the incidence and outcomes of end-stage renal disease (ESRD) in the U.S. between 1995 and 2006, found a significant increase in incidence rates among patients 5 to 39 years of age and in African Americans.

A second related study—the largest pediatric lupus nephritis-associated ESRD study to date—revealed high rates of adverse outcomes among children with ESRD due to lupus nephritis. Despite novel therapies, outcomes have not improved in over a decade. Both studies now appear online in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

More than 300,000 Americans are diagnosed with systemic lupus erythematosus (SLE), a chronic autoimmune disease that causes widespread inflammation, extreme fatigue, joint pain, and organ damage. Approximately 15% to 20% of all cases of SLE occur among children. Medical evidence has shown that up to 60% of adults and 80% of children with SLE develop nephritis—a potentially serious complication of lupus in which inflammation of the kidney could lead to renal failure. Prior studies report 10% to 30% of patients with lupus nephritis progress to ESRD within 15 years of diagnosis, despite aggressive treatment.

"Our studies examined trends in the incidence and outcomes of ESRD due to lupus nephritis for both adults and children in the U.S.," said lead study author Karen Costenbader, MD, MPH, from Brigham and Women's Hospital in Boston, Massachusetts. Researchers identified patients with lupus nephritis ESRD using data (1995-2006) from the U.S. Renal Data System, a national registry of patients who receive renal dialysis or kidney transplantation. Demographic and clinical characteristics, changes in rates of waitlisting for kidney transplant, kidney transplantation data, and all-cause mortality were examined.

The research team identified 12,344 cases of lupus nephritis ESRD with a mean age of onset of 41 years; 82% were female and 50% were African American. During the study period standardized incidence rates (SIRs) increased significantly among patients 5 to 39 years of age, African Americans, and in the U.S. Southeast. In fact, African Americans had a SIR of 6-7 times that of white patients. Researchers also noted that rates of pre-emptive kidney transplantation at ESRD onset slightly increased, but kidney transplantation rates within the first three years of ESRD declined. Rates of mortality did not change in over a decade of evaluation.

In the study specifically examining outcomes among children with lupus nephritis-associated ESRD, there were 583 cases identified and the mean age of onset was 16.2 years. Of those children with ESRD, 51% were African American, 39% were white, and 24% were Hispanic. Dr. Linda Hiraki, lead study author, with Dr. Costenbader and colleagues determined that within five years of ESRD onset 49% of children were wait-listed for kidney transplant, 33% received a kidney transplant and 22% died. The primary causes of mortality among children with ESRD were cardiopulmonary complications (31%) and infections (16%); risk of mortality in African American children was almost double that of white children.

While advances in treatment, such has preemptive kidney transplantation at ESRD onset, have been made in recent years, researchers found no improvement in outcomes. The team reported higher incidence rates in younger patients (ages 5-19 and 20-39 years), among African Americans, and in the Southern portion of the U.S. Age, race, ethnicity, insurance, and geographic region were associated with significant variation in 5-year wait-listing for kidney transplant, kidney transplantation and mortality among children with ESRD. "The changing demographics and poor survival rates highlight the ongoing challenge of caring for these patients," concluded Dr. Costenbader. "Further research is urgently needed to identify modifiable risk factors and interventions that can improve incidence rates and outcomes for children and adults with lupus nephritis ESRD."

These studies are published in Arthritis & Rheumatism. Media wishing to receive a PDF of the articles may contact healthnews@wiley.com.

Full citations:

Article: "Trends in the Incidence, Demographics and Outcomes of End-Stage Renal Disease Due to Lupus Nephritis in the U.S., 1995-2006." Karen H. Costenbader, Amrita Desai, Graciela S. Alarcón, Linda T. Hiraki, Tamara Shaykevich, M. Alan Brookhart, Elena Massarotti, Bing Lu, Daniel H. Solomon and Wolfgang C. Winkelmayer. Arthritis & Rheumatism; Published Online: March 28, 2011 (DOI: 10.1002/art.30350). http://doi.wiley.com/10.1002/art.30350.

Article: "End-Stage Renal Disease due to Lupus Nephritis among Children in the U.S., 1995-2006." Linda T. Hiraki, Bing Lu, Steven R. Alexander, Tamara Shaykevich, Graciela S. Alarcón, Daniel H. Solomon, Wolfgang Winkelmayer and Karen H. Costenbader. Arthritis & Rheumatism; Published Online: March 28, 2011 (DOI: 10.1002/art.30293). http://doi.wiley.com/10.1002/art.30293.

About the Journal

Arthritis & Rheumatism is an official journal of the American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP), a division of the College, and covers all aspects of inflammatory disease. The American College of Rheumatology (www.rheumatology.org) is the professional organization who share a dedication to healing, preventing disability, and curing the more than 100 types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members include practicing physicians, research scientists, nurses, physical and occupational therapists, psychologists, and social workers. For details, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1529-0131.

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.

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

More articles from Studies and Analyses:

nachricht WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf

nachricht First form of therapy for childhood dementia CLN2 developed
25.04.2018 | Universitätsklinikum Hamburg-Eppendorf

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: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

Im Focus: Dozens of binaries from Milky Way's globular clusters could be detectable by LISA

Next-generation gravitational wave detector in space will complement LIGO on Earth

The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...

Im Focus: Entangled atoms shine in unison

A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.

The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...

Im Focus: Computer-Designed Customized Regenerative Heart Valves

Cardiovascular tissue engineering aims to treat heart disease with prostheses that grow and regenerate. Now, researchers from the University of Zurich, the Technical University Eindhoven and the Charité Berlin have successfully implanted regenerative heart valves, designed with the aid of computer simulations, into sheep for the first time.

Producing living tissue or organs based on human cells is one of the main research fields in regenerative medicine. Tissue engineering, which involves growing...

Im Focus: Light-induced superconductivity under high pressure

A team of scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg investigated optically-induced superconductivity in the alkali-doped fulleride K3C60under high external pressures. This study allowed, on one hand, to uniquely assess the nature of the transient state as a superconducting phase. In addition, it unveiled the possibility to induce superconductivity in K3C60 at temperatures far above the -170 degrees Celsius hypothesized previously, and rather all the way to room temperature. The paper by Cantaluppi et al has been published in Nature Physics.

Unlike ordinary metals, superconductors have the unique capability of transporting electrical currents without any loss. Nowadays, their technological...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

 
Latest News

Supersonic waves may help electronics beat the heat

18.05.2018 | Power and Electrical Engineering

Keeping a Close Eye on Ice Loss

18.05.2018 | Information Technology

CrowdWater: An App for Flood Research

18.05.2018 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>