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Author Notes:

Correspondence: laura.plantinga@emory.edu

LCP conceived the study, analyzed the data, and drafted the manuscript.

SSL, SOP, and CD provided substantive clinical and scientific input on each version of the manuscript.

REP acquired the data and provided substantive scientific input on each version of the manuscript.

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 authors declare that they have no competing interests.

The datasets supporting the conclusions of this article are available via request from the United States Renal Data System (www.usrds.org).

Subjects:

Research Funding:

LCP, REP, and SOP are supported in part by 1R01MD 010290 through the National Institute on Minority Health and Health Disparities.

CD and SSL are supported in part by NIH R01AR065493 and CDC U01DP005119.

Comparison of vascular access outcomes in patients with end-stage renal disease attributed to systemic lupus erythematosus vs. other causes: A retrospective cohort study

Tools:

Journal Title:

BMC Nephrology

Volume:

Volume 17, Number 1

Publisher:

, Pages 64-64

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: U.S. hemodialysis patients with systemic lupus erythematosus (SLE) and end-stage renal disease (ESRD) are less likely than other ESRD patients to have a permanent vascular access (fistula or graft) in place at the dialysis start. We examined whether vascular access outcomes after dialysis start differed for SLE vs. other ESRD patients. Methods: Among U.S. patients initiating hemodialysis in 2010 with only a catheter (n = 40,911; 384 with SLE) and using a permanent access on first dialysis (n = 13,073; 48 with SLE), we examined the association of SLE status with time to first placement of a permanent access (among catheter-only patients) and to loss of access patency (among patients using a permanent access on first dialysis), both censored 1 year after dialysis start, using multivariable Cox proportional hazards models. Results: Among catheter-only patients, 46.1 % vs. 54.5 % of those with SLE-ESRD vs. other ESRD had a permanent access placed within 1 year after dialysis start. However, with adjustment, there was no association of 1-year placement with SLE status [HR = 1.00 (95 % CI, 0.86-1.17)]. SLE-ESRD vs. other ESRD patients starting dialysis with a permanent access were less likely to experience a 1-year loss of patency (43.8 % vs. 55.0 %), but this association was not statistically significant after adjustment [HR = 0.88 (0.57-1.37)]. Conclusion: These results suggest that SLE-ESRD patients starting dialysis with a catheter are not more likely to have a permanent access placed in the first year of dialysis, despite an observed lack of association of SLE status with subsequent loss of vascular access patency among those starting dialysis with a permanent access.

Copyright information:

© 2016 The Author(s). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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