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Author Notes:

Email Address: Laura Plantinga: laura.plantinga@emory.edu

LCP, CD, WM, and SSL contributed to the conception and design of the study. REP acquired the data.

LCP performed the analysis and LCP, REP, and CD interpreted the data.

LCP drafted the manuscript and REP, CD, SOP, WM, JC, and SSL revised the manuscript critically for important intellectual content.

All authors read and approved the final manuscript. LCP takes full responsibility for the accuracy and integrity of this work.

The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the U.S. government.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

The authors declare that they have no competing interests.

Subjects:

Research Funding:

L.C.P. was supported by Laney Graduate School, Emory University.

R.E.P. was supported in part by grants from the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH; ULl TR000454 and KL2TR000455). R.E.P. and S.O.P are both supported in part by R24MD008077-01 through the National Institute on Minority Health and Health Disparities.

C.D. and S.S.L. are supported in part by NIH R01AR065493 and CDC U01DP005119.

This article published with support from Emory Libraries' Open Access Publishing Fund.

Comparison of quality-of-care measures in US patients with end-stage renal disease secondary to lupus nephritis vs. other causes

Tools:

Journal Title:

BMC Nephrology

Volume:

Volume 16, Number 1

Publisher:

, Pages 39-39

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: Patients with end-stage renal disease (ESRD) due to lupus nephritis (LN-ESRD) may be followed by multiple providers (nephrologists and rheumatologists) and have greater opportunities to receive recommended ESRD-related care. We aimed to examine whether LN-ESRD patients have better quality of ESRD care compared to other ESRD patients. Methods: Among incident patients (7/05-9/11) with ESRD due to LN (n = 6,594) vs. other causes (n = 617,758), identified using a national surveillance cohort (United States Renal Data System), we determined the association between attributed cause of ESRD and quality-of-care measures (pre-ESRD nephrology care, placement on the deceased donor kidney transplant waitlist, and placement of permanent vascular access). Multivariable logistic and Cox proportional hazards models were used to estimate adjusted odds ratios (ORs) and hazard ratios (HRs). Results: LN-ESRD patients were more likely than other ESRD patients to receive pre-ESRD care (71% vs. 66%; OR = 1.68, 95% CI 1.57-1.78) and be placed on the transplant waitlist in the first year (206 vs. 86 per 1000 patient-years; HR = 1.42, 95% CI 1.34-1.52). However, only 24% had a permanent vascular access (fistula or graft) in place at dialysis start (vs. 36%; OR = 0.63, 95% CI 0.59-0.67). Conclusions: LN-ESRD patients are more likely to receive pre-ESRD care and have better access to transplant, but are less likely to have a permanent vascular access for dialysis, than other ESRD patients. Further studies are warranted to examine barriers to permanent vascular access placement, as well as morbidity and mortality associated with temporary access, in patients with LN-ESRD.

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© 2015 Plantinga et al.;

This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits , provided the original work is properly cited. This license requires .

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