Infection-related hospitalization and risk of end-stage renal disease in patients with systemic lupus erythematosus: a nationwide population-based study

doi:10.1093/ndt/gfw407

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Title:	Infection-related hospitalization and risk of end-stage renal disease in patients with systemic lupus erythematosus: a nationwide population-based study
Authors:	Lin, Chien-Hung Hung, Peir-Haur Hu, Hsiao-Yun Chen, Yann-Jang Guo, How-Ran Hung, Kuan-Yu
Contributors:	Natl Yang Ming Univ, Inst Clin Med Taipei City Hosp, Zhongxing Branch, Dept Pediat Ditmanson Med Fdn, Dept Internal Med,Chia Yi Christian Hosp Chia Nan Univ Pharm & Sci, Dept Appl Life Sci & Hlth Taipei City Hosp, Dept Educ & Res Natl Cheng Kung Univ, Dept Environm & Occupat Hlth, Coll Med Natl Cheng Kung Univ Hosp, Dept Occupat & Environm Med Natl Taiwan Univ Hosp, Dept Internal Med, Hsin Chu Branch
Keywords:	end-stage renal disease hospitalization infection National Health Insurance systemic lupus erythematosus
Date:	2017-10
Issue Date:	2018-11-30 15:54:44 (UTC+8)
Publisher:	Oxford Univ Press
Abstract:	Background. Infections are a major cause of morbidity in patients with systemic lupus erythematosus (SLE), and may lead to death. No nationally representative study of patients with SLE has examined the rates of infection-related hospitalization and the risk of end-stage renal disease (ESRD). Methods. We conducted a nationwide cohort study of 7326 patients with newly diagnosed SLE and no history of ESRD. All data were from Taiwan's National Health Insurance claims database for the period 2000-11. Results. Among all SLE patients, 316 (4.3%) developed ESRD (mean follow-up time: 8.1 years). Multivariate Cox regression analysis indicated that the risk of ESRD increased with the number of infection-related hospitalizations. For patients with three or more infection-related admissions, the hazard ratio (HR) for ESRD was 5.08 [95% confidence interval (CI): 3.74-6.90] relative to those with no infection-related admission. Analysis by type of infection indicated that bacteremia patients had the greatest risk for ESRD (HR: 4.82; 95% CI: 3.40-6.85). Analysis of age of SLE onset indicated that patients with juvenile-onset (< 18 years) and three or more infection-related hospitalizations had a greatly increased risk for ESRD (HR: 14.49; 95% CI: 5.34-39.33). Conclusions. Infection-related hospitalizations are associated with a significantly increased risk of ESRD in patients with SLE, especially those with juvenile-onset SLE. Among patients with different types of infectious diseases, those with bacteremia were more likely to develop ESRD.
Relation:	Nephrology Dialysis Transplantation, v.32, n.10, pp.1683-1690
Appears in Collections:	[Dept. of Life and Health Science] Periodical Articles

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