Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Continued treatment for lupus may boost survival of those patients with end-stage kidney disease

21.09.2011
Researchers at Albert Einstein College of Medicine of Yeshiva University have shown that close supervision by rheumatologists and the use of immunosuppressant drugs improve the survival of lupus patients with end-stage kidney disease—a finding that could reverse long-standing clinical practice. Their study appeared in the September 1 online edition of the Journal of Rheumatology.

At least 1.5 million Americans (more than 90 percent of them women) have lupus (officially known as lupus erythematosus), a chronic autoimmune disease that can damage many organs of the body. Treatment usually involves using immunosuppressive drugs to blunt the immune system's attack on the body. Kidney disease is a common complication of lupus, and up to 30 percent of patients with lupus-related kidney disease ultimately develop end-stage renal failure.

"The lupus disease process was thought to become inactive once kidney failure develops," said lead author Anna Broder, M.D., assistant professor of medicine at Einstein. "As a result, patients generally haven't been encouraged to continue with immunosuppressant medications or to follow up with their rheumatologists after developing end-stage kidney disease. But recent studies have suggested that lupus can indeed remain active after patients start dialysis or receive a kidney transplant."

"Our research shows for the first time that under-supervising and under-treating these lupus patients was associated with an increased risk of death," said Dr. Broder.

The Einstein researchers reviewed the charts of 80 lupus patients with end-stage renal disease who had been started on renal replacement therapy (i.e., either kidney dialysis or kidney transplant). Twenty-two of the patients had been seen frequently in rheumatology clinics (two or more visits per year), while the other 58 patients had been followed infrequently (fewer than two visits per year).

Four years after beginning renal replacement therapy, patients who continued to be treated with immunosuppressive medications were less likely to have died compared with patients who took only low doses of prednisone or no medication. (In fact, patients receiving no medication were 13 times more likely to have died compared with patients treated with a combination of immunosuppressive therapies.) The study also found that lupus patients who visited their rheumatologist at least twice a year after starting dialysis had significantly higher four-year survival rates compared with patients who went for fewer follow-up visits.

"If these findings are confirmed by future studies," said Dr. Broder, "they may significantly change the way lupus patients with end-stage renal failure are managed while on dialysis or after receiving kidney transplants."

Other authors of the study, "Under-treatment of disease activity in lupus patients with end-stage renal failure is associated with increased all-cause mortality," were Saakshi Khattri, M.D., Montefiore Medical Center; Ruchi Patel, M.D., Jacobi Medical Center; and senior author Chaim Putterman, M.D., professor of medicine and chief of rheumatology at Einstein. This research was supported in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health.

About Albert Einstein College of Medicine of Yeshiva University

Albert Einstein College of Medicine of Yeshiva University is one of the nation's premier centers for research, medical education and clinical investigation. During the 2009-2010 academic year, Einstein is home to 722 M.D. students, 243 Ph.D.students, 128 students in the combined M.D./Ph.D. program, and approximately 350 postdoctoral research fellows. The College of Medicine has 2,775 fulltime faculty members located on the main campus and at its clinical affiliates. In 2009, Einstein received more than $155 million in support from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Through its extensive affiliation network involving five medical centers in the Bronx, Manhattan and Long Island - which includes Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein - the College of Medicine runs one of the largest post-graduate medical training programs in the United States, offering approximately 150 residency programs to more than 2,500 physicians in training. For more information, please visit www.einstein.yu.edu

Kim Newman | EurekAlert!
Further information:
http://www.einstein.yu.edu

More articles from Health and Medicine:

nachricht How cancer metastasis happens: Researchers reveal a key mechanism
19.01.2018 | Weill Cornell Medicine

nachricht Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

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

Im Focus: Optical Nanoscope Allows Imaging of Quantum Dots

Physicists have developed a technique based on optical microscopy that can be used to create images of atoms on the nanoscale. In particular, the new method allows the imaging of quantum dots in a semiconductor chip. Together with colleagues from the University of Bochum, scientists from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute reported the findings in the journal Nature Photonics.

Microscopes allow us to see structures that are otherwise invisible to the human eye. However, conventional optical microscopes cannot be used to image...

Im Focus: Artificial agent designs quantum experiments

On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.

We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks Industry & Economy
Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Researchers reveal how microbes cope in phosphorus-deficient tropical soil

23.01.2018 | Earth Sciences

Opening the cavity floodgates

23.01.2018 | Life Sciences

Siberian scientists suggested a new method for synthesizing a promising magnetic material

23.01.2018 | Materials Sciences

VideoLinks Science & Research
Overview of more VideoLinks >>>