Tags

Type your tag names separated by a space and hit enter

Racial and Ethnic Differences in Mortality and Cardiovascular Events Among Patients With End-Stage Renal Disease Due to Lupus Nephritis.
Arthritis Care Res (Hoboken). 2015 Oct; 67(10):1453-62.AC

Abstract

OBJECTIVE

To identify racial and ethnic differences in mortality and cardiovascular (CV) risk among patients with end-stage renal disease (ESRD) due to lupus nephritis (LN).

METHODS

Within the US ESRD registry (1995-2008), we identified individuals ages >17 years with incident ESRD due to systemic lupus erythematosus. We ascertained demographics, clinical factors, and deaths from registry patient files and CV events (myocardial infarction, heart failure, and hemorrhagic and ischemic strokes) from inpatient Medicare claims. We calculated incidence rates (95% confidence intervals [95% CIs]) per 1,000 person-years for study events, stratified by race and ethnicity. We compared probabilities of the events among racial and ethnic groups using cumulative incidence function curves and multivariable-adjusted subdistribution proportional hazard ratios (HRsd), taking into account the competing events of kidney transplantation and death (for nonfatal CV events).

RESULTS

Of 12,533 patients with LN-associated ESRD, the mean ± SD age was 40.7 ± 14.9 years, 82% were women, and 49% were African American. The overall mortality rate was 98.1/1,000 person-years (95% CI 95.3-100.9). In multivariable models, Asian and Hispanic LN-associated ESRD patients had lower mortality than whites (HRsd 0.70 [95% CI 0.58-0.84] and 0.79 [95% CI 0.71-0.88], respectively), whereas African Americans had higher mortality (HRsd 1.27 [95% CI 1.18-1.36]). African American patients >40 years old had higher mortality than their white counterparts (HRsd 1.67 [95% CI 1.44-1.93]). African Americans were more likely to be admitted for heart failure or hemorrhagic stroke.

CONCLUSION

Among patients with LN-associated ESRD, Asians and Hispanics experienced lower mortality and CV event risks than whites, and African Americans had higher mortality and CV event risks than whites.

Authors+Show Affiliations

Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.University of Alabama at Birmingham.Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Baylor College of Medicine, Houston, Texas.Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25624071

Citation

Gómez-Puerta, Jose A., et al. "Racial and Ethnic Differences in Mortality and Cardiovascular Events Among Patients With End-Stage Renal Disease Due to Lupus Nephritis." Arthritis Care & Research, vol. 67, no. 10, 2015, pp. 1453-62.
Gómez-Puerta JA, Feldman CH, Alarcón GS, et al. Racial and Ethnic Differences in Mortality and Cardiovascular Events Among Patients With End-Stage Renal Disease Due to Lupus Nephritis. Arthritis Care Res (Hoboken). 2015;67(10):1453-62.
Gómez-Puerta, J. A., Feldman, C. H., Alarcón, G. S., Guan, H., Winkelmayer, W. C., & Costenbader, K. H. (2015). Racial and Ethnic Differences in Mortality and Cardiovascular Events Among Patients With End-Stage Renal Disease Due to Lupus Nephritis. Arthritis Care & Research, 67(10), 1453-62. https://doi.org/10.1002/acr.22562
Gómez-Puerta JA, et al. Racial and Ethnic Differences in Mortality and Cardiovascular Events Among Patients With End-Stage Renal Disease Due to Lupus Nephritis. Arthritis Care Res (Hoboken). 2015;67(10):1453-62. PubMed PMID: 25624071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial and Ethnic Differences in Mortality and Cardiovascular Events Among Patients With End-Stage Renal Disease Due to Lupus Nephritis. AU - Gómez-Puerta,Jose A, AU - Feldman,Candace H, AU - Alarcón,Graciela S, AU - Guan,Hongshu, AU - Winkelmayer,Wolfgang C, AU - Costenbader,Karen H, PY - 2014/08/07/received PY - 2014/12/11/revised PY - 2015/01/20/accepted PY - 2015/1/28/entrez PY - 2015/1/28/pubmed PY - 2015/12/17/medline SP - 1453 EP - 62 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 67 IS - 10 N2 - OBJECTIVE: To identify racial and ethnic differences in mortality and cardiovascular (CV) risk among patients with end-stage renal disease (ESRD) due to lupus nephritis (LN). METHODS: Within the US ESRD registry (1995-2008), we identified individuals ages >17 years with incident ESRD due to systemic lupus erythematosus. We ascertained demographics, clinical factors, and deaths from registry patient files and CV events (myocardial infarction, heart failure, and hemorrhagic and ischemic strokes) from inpatient Medicare claims. We calculated incidence rates (95% confidence intervals [95% CIs]) per 1,000 person-years for study events, stratified by race and ethnicity. We compared probabilities of the events among racial and ethnic groups using cumulative incidence function curves and multivariable-adjusted subdistribution proportional hazard ratios (HRsd), taking into account the competing events of kidney transplantation and death (for nonfatal CV events). RESULTS: Of 12,533 patients with LN-associated ESRD, the mean ± SD age was 40.7 ± 14.9 years, 82% were women, and 49% were African American. The overall mortality rate was 98.1/1,000 person-years (95% CI 95.3-100.9). In multivariable models, Asian and Hispanic LN-associated ESRD patients had lower mortality than whites (HRsd 0.70 [95% CI 0.58-0.84] and 0.79 [95% CI 0.71-0.88], respectively), whereas African Americans had higher mortality (HRsd 1.27 [95% CI 1.18-1.36]). African American patients >40 years old had higher mortality than their white counterparts (HRsd 1.67 [95% CI 1.44-1.93]). African Americans were more likely to be admitted for heart failure or hemorrhagic stroke. CONCLUSION: Among patients with LN-associated ESRD, Asians and Hispanics experienced lower mortality and CV event risks than whites, and African Americans had higher mortality and CV event risks than whites. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/25624071/Racial_and_Ethnic_Differences_in_Mortality_and_Cardiovascular_Events_Among_Patients_With_End_Stage_Renal_Disease_Due_to_Lupus_Nephritis_ L2 - https://doi.org/10.1002/acr.22562 DB - PRIME DP - Unbound Medicine ER -