Improved Mortality Trends in Lupus Nephritis Save

The mortality rate from end- stage renal disease (ESRD) in lupus nephritis (LN) patients has significantly decreased in the last decade.

Noting studies that showed premature mortality among ESRD lupus nephritis patients, researchers set out to examine if these trends have continued. Using national registry data through 2014, they studied 20,974 patients with incident ESRD due to LN between January 1, 1995 and December 31, 2014 and examined outcomes in 5-year blocks (1995–1999, 2000–2004, 2005–2009, 2010–2014).

Between 1995 through 2014, the mortality rate per 100 patient- years declined steadily:

• 1995–1999 - 11.1 (95% confidence interval [95% CI] 10.4–11.8)
• 2010–2014 - 6.7 (95% CI 6.2–7.2) (P trend < 0.01).

Compared with 1995–1999, the adjusted mortality hazard ratios in 2010–2014 were lower for whites (0.68;0.58–0.78), African Americans (0.67; 0.57–0.78), and for Hispanics (0.51; 0.38–0.69).

Deaths from cardiovascular disease (CVD) and infection declined by 44% and 63%, over this same period (p< 0.01 for both).

It appears that improving care in this high- risk population has lead to a reduction in all- cause mortality among white, African American, and Hispanic patients, with reduced risk of death from CVD and infection.