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Michael M. Ward, MD, MPH

Arch Intern Med. 2000;160:3136-3140.

Background  The availability of more effective treatments for severe lupus nephritis may have influenced the rate at which end-stage renal disease (ESRD) develops in these patients.

Objective  To examine changes in the incidence of ESRD due to lupus nephritis from 1982 to 1995.

Methods  All patients with incident ESRD included in the US Renal Data System from 1982 to 1995 were studied. The US Renal Data System includes information on all patients who receive Medicare-reimbursed renal replacement therapy, who constitute approximately 94% of all patients with ESRD in the United States. The incidence of ESRD due to lupus nephritis in each year, standardized to the age-sex-ethnicity composition of the US general population in 1990, was computed in this serial cross-sectional study.

Results  The standardized incidence rate of ESRD due to lupus nephritis increased steadily from 1.16 cases per million person-years in 1982 to 3.08 cases per million person-years in 1995. The rate of increase was comparable to that of ESRD due to all other primary renal diseases.

Conclusion  The incidence of ESRD due to lupus nephritis increased steadily over the 14-year study period, despite the introduction of efficacious new treatment regimens for lupus nephritis during this time.

From the Medical Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif; and the Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, Calif.
The author has no commerical, proprietary, or financial interest in the products or companies described in this article.

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