Featured Research

from universities, journals, and other organizations

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

Date:
November 7, 2011
Source:
Wiley-Blackwell
Summary:
Newly published research shows that more patients with end-stage renal disease caused by lupus nephritis choose hemodialysis as their initial kidney replacement therapy over peritoneal dialysis and preemptive kidney transplantation. Results of the study also found that African-Americans, Medicaid recipients, those without health insurance, and the unemployed had significantly reduced initiation of peritoneal dialysis.

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.

Related Articles


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.


Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.


Journal Reference:

  1. Amy Devlin, Sushrut Waikar, Daniel H. Solomon, Bing Lu, Tamara Shakevich, Graciela S. Alarcσn, Wolfgang C. Winkelmayer, Karen H. Costenbader. Variation in initial kidney replacement therapy for end-stage renal disease due to LN in the U.S.. Arthritis Care & Research, 2011; DOI: 10.1002/acr.20607

Cite This Page:

Wiley-Blackwell. "Most lupus nephritis patients with end-stage renal disease opt for hemodialysis therapy." ScienceDaily. ScienceDaily, 7 November 2011. <www.sciencedaily.com/releases/2011/11/111107033946.htm>.
Wiley-Blackwell. (2011, November 7). Most lupus nephritis patients with end-stage renal disease opt for hemodialysis therapy. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2011/11/111107033946.htm
Wiley-Blackwell. "Most lupus nephritis patients with end-stage renal disease opt for hemodialysis therapy." ScienceDaily. www.sciencedaily.com/releases/2011/11/111107033946.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) — IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) — A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) — The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) — An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins