AVALIAÇÃO DA MORTALIDADE NOS PACIENTES COM LÚPUS ERITEMATOSO SISTÊMICO EM DIÁLISE REGULAR: UM ESTUDO MULTICÊNTRICO NO GRANDE RIO
MEDICINA
CIÊNCIAS MÉDICAS
Mortalidade
Diálise
CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA
Abstract
Background: Data about the survival rate of lupus patients on dialysis is controversial. The present controlled prospective study reports the survival of systemic lupus erythemathosus (SLE) patients undergoing dialysis and analyzes
factors associated with mortality. Methods: Twenty dialysis centers were visited between May/2003 and February/2004. Disease activity was evaluated using the SLE disease activity index (SLEDAI) without the renal related parameters (nrSLEDAI); Data collection was performed at entrance in the study. The control group consisted of hemodialysis
patients without SLE matched for gender, age, dialysis modality, time on dialysis, and dialysis associated hepatitis C virus (HCV) infection. Patients were prospectively followed for 60 months. Kaplan-Meier method was used to estimate survival. Associations of risk factors with mortality were tested using the Cox proportional hazards model. Results: Each group was composed of 57 patients. In the multivariate
analysis, only nrSLEDAI>8 (HR 6.368, 95%CI 1.798-22.548, P=0.004), and urea reduction ratio (HR 0.953, 95%CI 0.917-0.990, P=0.014) were independently associated with mortality in lupus patients. The five year survival rate of the control
group and the one from SLE patients with nrSLEDAI≤8 were similar (83% and 73%, respectively) but significantly better than the one of SLE patients with nrSLEDAI>8 (17%), P<0.001. Conclusions: The IRU proved to be a protective factor against mortality. However, a high nrSLEDAI was strongly associated with five-year mortality in lupus patients on dialysis.
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Subject(s)
Lúpus eritematoso sistêmicoMEDICINA
CIÊNCIAS MÉDICAS
Mortalidade
Diálise
CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA