TY - JOUR
T1 - Association between antiphospholipid antibodies and all-cause mortality among end-stage renal disease patients with and without SLE
T2 - A retrospective cohort study
AU - Broder, Anna
AU - Mowrey, Wenzhu B.
AU - Kim, Mimi
AU - Murakhovskaya, Irina
AU - Billett, Henny
AU - Neugarten, Joel
AU - Costenbader, Karen H.
AU - Putterman, Chaim
N1 - Publisher Copyright:
© The Author 2015.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Objective. To investigate the association between the presence of aPL and/or LA and all-cause mortality among end-stage renal disease (ESRD) patients with and without SLE. Methods. We included ESRD patients>18 years old followed at an urban tertiary care centre between 1 January 2006 and 31 January 2014 who had aPL measured at least once after initiating haemodialysis. All SLE patients met ACR/SLICC criteria. APL/LA+ was defined as aCL IgG or IgM>40 IU, anti-b2glycoprotein1 IgG or IgM≫40 IU or LA+. Deaths as at 31 January 2014 were captured in the linked National Death Index data. Time to death was defined from the first aPL measurement. Results. We included 34 SLE ESRD and 64 non-SLE ESRD patients; 30 patients died during the study period. SLE ESRD patients were younger [40.4 (12.5) vs 51.9 (18.1) years, P = 0.001] and more were women (88.2% vs 54.7%, P<0.001) vs non-SLE ESRD patients. The frequency of aPL/LA+ was 24% in SLE and 13% in non-SLE ESRD (P = 0.16). Median (inter-quartile range) follow-up time was 1.6 (0.3-3.5) years in SLE and 1.4 (0.4-3.2) years in non-SLE, P = 0.74. The adjusted hazard ratio (HR) for all-cause mortality for SLE patients who were aPL/LA+ vs aPL/LA- was 9.93 (95% CI 1.33, 74.19); the adjusted HR for non-SLE aPL/LA+ vs aPL/LA- was 0.77 (95% CI 0.14, 4.29). Conclusion. SLE ESRD patients with aPL/LA+ had higher all-cause mortality risk than SLE ESRD patients without these antibodies, while the effects of aPL/LA on mortality were comparable among non-SLE ESRD patients.
AB - Objective. To investigate the association between the presence of aPL and/or LA and all-cause mortality among end-stage renal disease (ESRD) patients with and without SLE. Methods. We included ESRD patients>18 years old followed at an urban tertiary care centre between 1 January 2006 and 31 January 2014 who had aPL measured at least once after initiating haemodialysis. All SLE patients met ACR/SLICC criteria. APL/LA+ was defined as aCL IgG or IgM>40 IU, anti-b2glycoprotein1 IgG or IgM≫40 IU or LA+. Deaths as at 31 January 2014 were captured in the linked National Death Index data. Time to death was defined from the first aPL measurement. Results. We included 34 SLE ESRD and 64 non-SLE ESRD patients; 30 patients died during the study period. SLE ESRD patients were younger [40.4 (12.5) vs 51.9 (18.1) years, P = 0.001] and more were women (88.2% vs 54.7%, P<0.001) vs non-SLE ESRD patients. The frequency of aPL/LA+ was 24% in SLE and 13% in non-SLE ESRD (P = 0.16). Median (inter-quartile range) follow-up time was 1.6 (0.3-3.5) years in SLE and 1.4 (0.4-3.2) years in non-SLE, P = 0.74. The adjusted hazard ratio (HR) for all-cause mortality for SLE patients who were aPL/LA+ vs aPL/LA- was 9.93 (95% CI 1.33, 74.19); the adjusted HR for non-SLE aPL/LA+ vs aPL/LA- was 0.77 (95% CI 0.14, 4.29). Conclusion. SLE ESRD patients with aPL/LA+ had higher all-cause mortality risk than SLE ESRD patients without these antibodies, while the effects of aPL/LA on mortality were comparable among non-SLE ESRD patients.
KW - Antiphospholipid antibodies
KW - End stage
KW - Haemodialysis
KW - Lupus nephritis
KW - Renal disease
KW - Systemic lupus erythematosus
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U2 - 10.1093/rheumatology/kev423
DO - 10.1093/rheumatology/kev423
M3 - Article
C2 - 26705328
AN - SCOPUS:84965075882
SN - 1462-0324
VL - 55
SP - 817
EP - 825
JO - Rheumatology and Rehabilitation
JF - Rheumatology and Rehabilitation
IS - 5
ER -