End-stage renal disease due to lupus nephritis among children in the US, 1995-2006

Related Experiment Video

Updated: Jun 3, 2026

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
09:43

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice

Published on: June 8, 2022

Linda T Hiraki1, Bing Lu, Steven R Alexander

  • 1Harvard School of Public Health and Brigham and Women's Hospital, Boston, Massachusetts, USA. lhiraki@hsph.harvard.edu

Arthritis and Rheumatism
|March 30, 2011
PubMed

Insights

Predictors like age, race, insurance, and region significantly impact kidney transplant wait-listing and survival for children with lupus nephritis-related end-stage renal disease (ESRD). Outcomes vary widely based on these demographic and socioeconomic factors.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology
  • Renal Disease Epidemiology

Background:

  • Lupus nephritis is a leading cause of end-stage renal disease (ESRD) in children.
  • Outcomes for pediatric ESRD patients, including kidney transplantation and mortality, can be influenced by various factors.
  • Understanding predictors is crucial for equitable access to transplantation and improved survival.

Purpose of the Study:

  • To identify predictors of wait-listing for kidney transplantation.
  • To identify predictors of receiving a kidney transplant.
  • To identify predictors of mortality in children with lupus nephritis-associated ESRD.

Main Methods:

  • Utilized the US Renal Data System (1995-2006) to identify children (5-18 years) with incident lupus nephritis-associated ESRD.
  • Investigated demographic, clinical characteristics, causes of death, and predictors of wait-listing, transplantation, and mortality within 5 years of ESRD onset.
  • Employed Cox proportional hazards models to analyze the data.

Main Results:

  • Of 583 children, 49% were wait-listed, 33% received transplants, and 22% died within 5 years.
  • Cardiopulmonary issues (31%) and infections (16%) were primary causes of death.
  • Significant disparities observed: African American and Hispanic children, those with Medicaid, and older children had lower transplant rates. African American children faced nearly double the mortality risk compared to white children. Geographic region also influenced wait-listing and transplant rates.

Conclusions:

  • Age, race, ethnicity, insurance type, and geographic region are significant predictors of kidney transplantation wait-listing, receipt, and mortality in US children with lupus nephritis-associated ESRD.
  • These factors contribute to substantial variations in outcomes, highlighting potential inequities in the healthcare system.
  • Further research and targeted interventions are needed to address these disparities and improve outcomes for all children with ESRD.
Abstract

More Related Videos

Mouse Model of Acute to Chronic Kidney Disease Transition Induced by Renal Ischemia/Reperfusion Injury07:02

Mouse Model of Acute to Chronic Kidney Disease Transition Induced by Renal Ischemia/Reperfusion Injury

Published on: February 10, 2026

Related Concept Videos

Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...