scholarly journals Mortality in a cohort of Egyptian systemic lupus erythematosus patients: retrospective two-center study

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Abdelkawy Moghazy ◽  
Amira M. Ibrahim
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Glomerular Filtration Rate ◽  
Lupus Erythematosus ◽  
End Stage Renal Disease ◽  
Filtration Rate ◽  
Causes Of Death ◽  
Systemic Lupus ◽  
Cardiopulmonary Complications ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Systemic lupus erythematosus is a debilitating autoimmune disease with major contribution to the worldwide morbidity and mortality. This study aimed to investigate the causes of mortality in systemic lupus erythematosus (SLE) patients and the relation between clinical activity, disease-associated end-organ damage, laboratory markers and mortality. Results Among the 771 patients who were successfully followed up, 34 patients (4.4%) died. The leading causes of death were infectious causes (35.29%), cardiopulmonary causes (26.48%), renal causes (14.7%), unknown causes (14.7%), neuropsychiatric causes (5.88%), and lastly gastrointestinal causes (2.94%). Subjects who died had lower complement 3 level, more anemia, lymphopenia, neutropenia, leukocytosis, thrombocytopenia, decreased glomerular filtration rate, higher incidence of infection, end-stage renal disease, and cardiopulmonary complications. Higher glucocorticoid dosage with more immunosuppressant (mofetil and cyclophosphamide) treatment was observed in patients who died. SLE disease Activity Index and Systemic Lupus International Collaborating Clinics damage index were both significantly higher in deceased persons. Multivariable hazards regression analysis revealed that lymphopenia (p = 0.017), decreased glomerular filtration rate < 50% (p = 0.002) with end-stage renal disease (p = 0.001), and high steroid daily use of > 40 mg (p = 0.016) were independent risk factors for the mortality of SLE patients. Conclusion Infections and cardiopulmonary complications are the leading causes of death in two centers caring for Egyptian SLE patients. Lymphopenia, end-stage renal failure, and high steroid daily use were associated with poor outcomes.

Renal Transplantation in Systemic Lupus Erythematosus: Comparison of Graft Survival With Other Causes of End-stage Renal Disease

2019 ◽  
Vol 15 (3) ◽  
pp. 140-145
Author(s):  
Gabriel Horta-Baas ◽  
Adolfo Camargo-Coronel ◽  
Dafhne Guadalupe Miranda-Hernández ◽  
Leslie Gabriela Gónzalez-Parra ◽  
María del Socorro Romero-Figueroa ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Transplantation ◽  
Renal Disease ◽  
Graft Survival ◽  
Lupus Erythematosus ◽  
End Stage Renal Disease ◽  
Systemic Lupus ◽  
Stage Renal Disease ◽  
End Stage

Successful treatment with belimumab in a patient with refractory systemic lupus erythematosus after initiation of hemodialysis: Considering the synergistic effect of belimumab and immunological burn-out phenomenon in end stage renal disease patients on hemodialysis

2020 ◽  
Author(s):  
Shota Ogura ◽  
Kazunori Karasawa ◽  
Wataru Ono ◽  
Ayaki Ito ◽  
Momoko Seki ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
B Cells ◽  
Renal Disease ◽  
Lupus Erythematosus ◽  
End Stage Renal Disease ◽  
Systemic Lupus ◽  
Transitional B Cells ◽  
First Case ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background: In patients with systemic lupus erythematosus (SLE), disease activity can persist even after initiating dialysis. However, guidelines for the treatment of patients with SLE after dialysis is initiated have not yet been established. Case presentation: We describe the case of a 62-year-old Japanese woman who was diagnosed with SLE at age 12, progressed to end-stage renal disease (ESRD), and initiated hemodialysis for lupus nephritis. However, SLE activity persisted after hemodialysis. Cyclophosphamide and mycophenolate mofetil were administered in addition to prednisolone and immunoadsorption, but this treatment strategy was limited by side effects. The patient was subsequently treated with belimumab, and the activity of SLE decreased rapidly. Conclusions: ESRD patients with SLE show no significant decrease in transitional B cells, and have elevated levels of B-cell activating factor (BAFF). Both transitional B cells and BAFF are important therapeutic targets for belimumab, indicating that patients with ESRD may benefit from belimumab therapy. However, the effects of belimumab may be potentiated in patients with uremia, who may be more susceptible to adverse events such as infections. Patients with SLE who receive belimumab after initiation of hemodialysis therefore require careful follow-up. Here we report the first case of belimumab administration in a patient with SLE after initiation of hemodialysis.

Systemic lupus erythematosus diagnosis impacts clinical outcomes of arteriovenous fistulas in comparison to other end-stage renal disease etiologies

Vascular ◽  
2020 ◽  
pp. 170853812093640
Author(s):  
Cesar Cuen-Ojeda ◽  
Virginia Pascual-Ramos ◽  
Irazú Contreras-Yáñez ◽  
Javier E Anaya-Ayala ◽  
Erika Elenes-Sanchez ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Disease ◽  
Lupus Erythematosus ◽  
End Stage Renal Disease ◽  
Primary Patency ◽  
Control Group ◽  
Systemic Lupus ◽  
Arteriovenous Fistulas ◽  
Stage Renal Disease ◽  
End Stage

Objectives Arteriovenous fistulas primary patency at one-year occurs in 43–85% of the patients with end-stage renal disease. The diagnosis attributable to end-stage renal disease has been suggested to impact arteriovenous fistulas outcomes. The objective was to compare primary patency at one week, 1, 3, 6, and 12 months of follow-ups, among systemic lupus erythematosus patients and two control groups; additionally, we evaluated the impact of systemic lupus erythematosus to predict early patency loss. Methods A retrospective review of charts from arteriovenous fistulas created between 2008 and 2017 was performed. One-hundred thirty-four patients were identified and classified according to end-stage renal disease attributable diagnosis as: systemic lupus erythematosus cases ( N = 14), control-group-1 (91 patients with primarily diabetes and hypertension), and control-group-2 (29 patients with idiopathic end-stage renal disease). A case–control matched design (1:2:1) was proposed. Logistic regression analysis and Kaplan–Meier curves were used. Institutional Review Board approval was obtained. Results More systemic lupus erythematosus patients lost primary patency at 3 (28.6%) and 12 months (71.4%) than patients from control-groups-1 (vs. 3.6% and 35.7%, respectively) and -2 (vs. 0% and 14.3%, respectively), ( p ≤ 0.011 for both). Days of primary patency survival were shorter in systemic lupus erythematosus patients ( p = 0.003). Systemic lupus erythematosus diagnosis was the only factor associated with early patency loss, HR: 3.141, 95%CI: 1.161–8.493 (systemic lupus erythematosus diagnosis vs. control-group-1) and HR: 12.582, 95%CI: 1.582–100.035 (systemic lupus erythematosus diagnosis vs. control-group-2). Conclusions Diagnosis attributable to end-stage renal disease has a major impact on arteriovenous fistula outcomes in patients. Systemic lupus erythematosus patients have an increased risk of arteriovenous fistulas patency loss within the first six months of follow-up. Patients with idiopathic end-stage renal disease had an excellent one year arteriovenous fistula patency survival.

Activity of Systemic Lupus Erythematosus in End-Stage Renal Disease Patients: Study in a Brazilian Cohort

2005 ◽  
Vol 25 (6) ◽  
pp. 596-603 ◽  
Author(s):  
Francinne M. Ribeiro ◽  
Marco Antonio P. Leite ◽  
Guillermo Coca Velarde ◽  
Cristianne L. Fabris ◽  
Renata C. Santos ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Disease ◽  
Lupus Erythematosus ◽  
End Stage Renal Disease ◽  
Systemic Lupus ◽  
Stage Renal Disease ◽  
End Stage ◽  
Brazilian Cohort

scholarly journals Incidence of End-Stage Renal Disease Among Newly Diagnosed Systemic Lupus Erythematosus Patients: The Georgia Lupus Registry

2016 ◽  
Vol 68 (3) ◽  
pp. 357-365 ◽  
Author(s):  
Laura Plantinga ◽  
S. Sam Lim ◽  
Rachel Patzer ◽  
William McClellan ◽  
Michael Kramer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Disease ◽  
Lupus Erythematosus ◽  
End Stage Renal Disease ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Stage Renal Disease ◽  
End Stage
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