Lin CH, et al. - This study focused on the rates of infection-related hospitalization and the risk of end-stage renal disease (ESRD) in systemic lupus erythematosus (SLE) patients. An association was evident between infection-related hospitalizations and significantly increased risk of ESRD in this patient population, particularly in those with juvenile-onset SLE. ESRD was more likely in patients with bacteremia.

Methods

• This nationwide cohort study was performed on 7326 patients with newly diagnosed SLE and no history of ESRD.
• Researchers extracted all data from Taiwan’s National Health Insurance claims database for the period 2000–11.

Results

• Data showed that 316 (4.3%) developed ESRD (mean follow-up time: 8.1 years) among all SLE patients.
• It was evident in multivariate Cox regression analysis that the risk of ESRD increased with the number of infection-related hospitalizations.
• Researchers found that for patients with three or more infection-related admissions, the hazard ratio (HR) for ESRD was 5.08 [95% confidence interval (CI): 3.74–6.90] relative to those with no infection-related admission.
• They also found that bacteremia patients had the greatest risk for ESRD (HR: 4.82; 95% CI: 3.40–6.85) as revealed via analysis by type of infection.
• In addition, findings from the analysis of age of SLE onset demonstrated that patients with juvenile-onset (<18 years) and three or more infection-related hospitalizations had a greatly increased risk for ESRD (HR: 14.49; 95% CI: 5.34–39.33).