Continued Treatment For Lupus May Boost Survival of Those Patients with End-Stage Kidney Disease
BRONX, N.Y., Sept. 20, 2011 /PRNewswire-USNewswire/ -- Researchers at Albert Einstein College of Medicine of Yeshiva University have shown that close supervision by rheumatologists and the use of immunosuppressant drugs improve the survival of lupus patients with end-stage kidney disease—a finding that could reverse long-standing clinical practice. Their study appeared in the September 1 online edition of the Journal of Rheumatology.
At least 1.5 million Americans (more than 90 percent of them women) have lupus (officially known as lupus erythematosus), a chronic autoimmune disease that can damage many organs of the body. Treatment usually involves using immunosuppressive drugs to blunt the immune system's attack on the body. Kidney disease is a common complication of lupus, and up to 30 percent of patients with lupus-related kidney disease ultimately develop end-stage renal failure.
"The lupus disease process was thought to become
inactive once kidney failure develops," said lead author
Anna Broder, M.D., assistant professor of
"Our research shows for the first time that
under-supervising and under-treating these lupus patients was
associated with an increased risk of death," said Dr. Broder. The Einstein researchers reviewed the charts of 80
lupus patients with end-stage renal disease who had been started on
renal replacement therapy (i.e., either kidney dialysis or kidney
transplant). Twenty-two of the patients had been seen frequently in
rheumatology clinics (two or more visits per year), while the other
58 patients had been followed infrequently (fewer than two visits
per year). Four years after beginning renal replacement therapy,
patients who continued to be treated with immunosuppressive
medications were less likely to have died compared with patients
who took only low doses of prednisone or no medication. (In
fact, patients receiving no medication were 13 times more likely to
have died compared with patients treated with a combination of
immunosuppressive therapies.) The study also found that lupus
patients who visited their rheumatologist at least twice a year
after starting dialysis had significantly higher four-year survival
rates compared with patients who went for fewer follow-up visits.
"If these findings are confirmed by future studies,"
said Dr. Broder, "they may significantly change the way lupus
patients with end-stage renal failure are managed while on dialysis
or after receiving kidney transplants." Other authors of the study, "Under-treatment of disease
activity in lupus patients with end-stage renal failure is
associated with increased all-cause mortality," were Saakshi
Khattri, M.D., Montefiore Medical Center; Ruchi Patel, M.D., Jacobi Medical Center; and
senior author
Chaim Putterman, M.D., professor of medicine and chief of
Albert Einstein
College of Medicine of Yeshiva
University SOURCE Albert Einstein
College of Medicine
Albert Einstein
College of Medicine of Yeshiva University is one of the
nation's premier centers for research, medical education and
clinical investigation. During the 2010-2011 academic year,
Einstein is home to 724 M.D. students,
256 Ph.D. students,
122 students in the combined M.D./Ph.D. program, and
375 postdoctoral
research fellows. The College of Medicine has 2,770 full time
faculty members located on the main campus and at its clinical
affiliates. In 2010, Einstein received nearly
$200 million in support from the NIH.
This includes the funding of major research centers at
Einstein in diabetes, cancer, liver disease, and AIDS. Other
areas where the College of Medicine is concentrating its efforts
include developmental brain research, neuroscience, cardiac
disease, and initiatives to reduce and eliminate ethnic and racial
health disparities. Through its extensive affiliation network
involving five medical centers in the Bronx, Manhattan and Long
Island – which includes Montefiore Medical Center, The
University Hospital and Academic Medical Center for Einstein
– the College of Medicine runs one of the largest
post-graduate medical training programs in the United States, offering approximately 150
residency programs to more than 2,500 physicians in training. For
more information, please visit www.einstein.yu.edu
CONTACT: Kimberly Newman, +1-718-430-3101, Sciencenews@einstein.yu.edu
Web Site: http://www.aecom.yu.edu
Posted: September 2011
