Long-Term Clinical Outcomes of Lupus Nephritis Patients Undergoing Peritoneal Dialysis: A Matched, Case-Control Study

Area of Science:

• Nephrology
• Rheumatology
• Clinical Outcomes Research

Background:

• Long-term clinical outcomes of peritoneal dialysis (PD) for lupus nephritis (LN) patients remain under-researched.
• Understanding PD prognosis in LN is crucial for patient management and treatment strategies.

Purpose of the Study:

• To investigate the long-term clinical outcomes, including survival and technique failure, of Chinese patients with lupus nephritis undergoing peritoneal dialysis.
• To compare these outcomes with a matched non-diabetic control group.

Main Methods:

• A retrospective case-control study included 28 LN patients on PD (treatment >90 days) and 56 matched non-diabetic controls.
• Data collected from January 2006 to December 2012, with follow-up until December 2017.
• Primary outcome: all-cause mortality; Secondary outcomes: technique failure, hospitalization, and infection rates.

Main Results:

• After a median follow-up of 53.1 months, LN patients had significantly lower 1-, 3-, and 5-year survival rates (p=0.035).
• Lupus nephritis was an independent risk factor for technique failure (HR: 2.87) but not significantly associated with all-cause mortality after adjustment.
• LN patients exhibited higher hospitalization and infection rates.

Conclusions:

• Lupus nephritis patients undergoing peritoneal dialysis demonstrate poorer patient survival and technique survival.
• Higher rates of hospitalization and infection are associated with PD in LN patients, highlighting significant challenges.