March 28, 2019
A new study published this March in Arthritis & Rheumatology found that deaths among patients with end-stage renal disease (ESRD) due to lupus nephritis (LN) fell significantly — by 32% —over the past two decades. The study took into account deaths from all causes, including deaths from cardiovascular disease (CVD) and infection.
The authors of the study compared mortality rates from CVD and from infection during the 20-year period. Results showed that deaths declined from CVD by 44 percent and from infection by 63 percent during the study period. Improved survival was seen among patients of all races, male and female.
Drs. April Jorge and Zachary Wallace, along with colleagues at Harvard Medical School, named several reasons for these improved survival rates: better overall care, less reliance on immunosuppressive treatments, and improvements in the management of lupus itself.
LN – inflammation of the kidneys — affects about 50 percent of adults with lupus, while approximately one-third of that group develops ESRD, defined as kidney failure when the kidneys stop working.
The authors relied on data from the national registry of patients with ESRD. However, the registry excludes people who are not legal residents of the United States, an “underserved and vulnerable population,” the authors note. Still, despite this limitation, the study’s findings offer a much-needed benchmark—a new standard against which further improvements in care can be measured.