Academic Journal
Referral and evaluation for kidney transplantation among patients with lupus nephritis-related end-stage kidney disease
| العنوان: | Referral and evaluation for kidney transplantation among patients with lupus nephritis-related end-stage kidney disease |
|---|---|
| المؤلفون: | McPherson, Laura, Plantinga, Laura C, Howards, Penelope P, Kramer, Michael, Pastan, Stephen O, Patzer, Rachel E |
| المساهمون: | National Institute of Diabetes and Digestive and Kidney Diseases, National Institute on Minority Health and Health Disparities |
| المصدر: | Lupus ; volume 33, issue 1, page 48-57 ; ISSN 0961-2033 1477-0962 |
| بيانات النشر: | SAGE Publications |
| سنة النشر: | 2023 |
| الوصف: | Objective For the majority of patients with lupus nephritis-related end-stage kidney disease (LN-ESKD), kidney transplant is associated with better outcomes than dialysis. Access to kidney transplant requires an initial referral to a transplant center and medical evaluation prior to waitlisting. The study’s objective was to examine access to these early steps in the kidney transplant process among patients with LN-ESKD. Methods Adults who began treatment for ESKD in the Southeast, Northeast, New York, or Ohio River Valley U.S. regions from 1/1/2012 to 12/31/2019, followed through 6/30/2021, were identified from the United States Renal Data System. Referral and evaluation start data were collected from 28 of 48 transplant centers across these regions. The exposure was primary cause of ESKD (LN-ESKD vs other-ESKD). The outcomes were referral and evaluation start at a transplant center. Cox models quantified the association between LN-ESKD (vs other-ESKD) and referral and evaluation start. Results Among 192,318 patients initiating treatment for ESKD, 0.4% had LN-ESKD. Over half (58%) of LN-ESKD patients were referred before study end, and among those referred, 66% started the evaluation. In adjusted analyses, patients with LN-ESKD were referred (HR: 1.09, 95% CI: 0.99, 1.19) and started the transplant evaluation (HR: 1.13, 95% CI: 1.00, 1.28) at a higher rate than patients with other-ESKD. Among referred patients with LN-ESKD, the median time from ESKD start to referral was 2.9 months (IQR: <1 to 11.7 months), which is similar to patients with other-ESKD (median 2.6 months, IQR: <1 to 8.8 months). Conclusions Among incident patients with ESKD, having a primary diagnosis of LN-ESKD versus other-ESKD is associated with higher rates of early transplant access outcomes. Despite this, patients with LN-ESKD (vs other-ESKD) are less likely to be preemptively referred (i.e., referred prior to ESKD start) for kidney transplant. While providers may no longer be delaying the early steps in the kidney transplantation ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1177/09612033231219739 |
| الاتاحة: | https://doi.org/10.1177/09612033231219739 https://journals.sagepub.com/doi/pdf/10.1177/09612033231219739 https://journals.sagepub.com/doi/full-xml/10.1177/09612033231219739 |
| Rights: | https://journals.sagepub.com/page/policies/text-and-data-mining-license |
| رقم الانضمام: | edsbas.5D653268 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/09612033231219739 |
|---|