Lupus & antiphospholipid syndrome
Trends of preemptive kidney transplantation in lupus compared to other primary diseases leading to end stage kidney disease in the United States of America
Authors' conclusion
PKT trends increased from 1985 to 2019 in patients with lupus, PKD and GD. PKT patients with lupus have lower risk of KAF and mortality compared to patients with DM.
Study context
- Population
- Incident End-stage Kidney Disease (ESKD) patients in the United States Renal Data System (USRDS)3,001,746 non-lupus
- Exposure
- Lupus vs non-lupus primary diseases leading to ESKD
- Lupusn = 33,415
- Outcome
- Trends of preemptive kidney transplantation (PKT)
Methodological detailsregistry-based (USRDS), Cochran-Armitage trend tests, adjusted Cox models
- Registry-based (USRDS)
- Cochran-Armitage trend tests
- Adjusted Cox models
Main finding
As reported in the abstract
PKT trends
Lupus
3.02% to 4.65%
Polycystic kidney disease (PKD)
3.14% to 16.71%
Glomerular diseases (GD)
3.94% to 5.90%
DM
2.11% to 0.71%
Hypertension (HTN)
1.15% to 0.92%
Other diseases (OD)
3.89% to 3.60%
- Increase in Lupus
- P = 0.001
- Increase in PKD
- P < 0.001
- Increase in GD
- P < 0.001
- Decrease in DM
- P < 0.001
- Decrease in HTN
- P < 0.001
- Decrease in OD
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | |
|---|---|---|---|
| Kidney allograft failure (KAF) in PKT recipients, rate per 100 patient-yearsLupusvs DMAdjusted Cox models | Lupus 4.40 per 100 patient-years · PKD 2.47 per 100 patient-years · GD 4.28 per 100 patient-years · OD 4.84 per 100 patient-years · DM 6.24 per 100 patient-years · HTN 7.42 per 100 patient-years | 0.85 (0.76–0.95) | |
| All-cause mortality in PKT recipients, rateLupusvs DMAdjusted models | Lupus 2.59 · PKD 2.20 · GD 2.62 · OD 2.99 · HTN 6.39 · DM 6.49 | 0.56 (0.50–0.64) | |
| 0.512Hazard ratio (log scale) |
Original publication
Trends of preemptive kidney transplantation in lupus compared to other primary diseases leading to end stage kidney disease in the United States of America. Lupus. Published 20 May 2025. doi:10.
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