Kidney Transplantation in Lupus Nephritis: Can We Do Even Better?
Authors: Nitender Goyal, Daniel E. Weiner, Andrew S. Levey
Journal: Annals of Internal Medicine (2019)

Editorials19 February 2019Kidney Transplantation in Lupus Nephritis: Can We Do Even Better?Nitender Goyal, MD, Daniel E. Weiner, MD, MS, and Andrew S. Levey, MDNitender Goyal, MDTufts Medical Center, Boston, Massachusetts (N.G., D.E.W., A.S.L.)Search for more papers by this author, Daniel E. Weiner, MD, MSTufts Medical Center, Boston, Massachusetts (N.G., D.E.W., A.S.L.)Search for more papers by this author, and Andrew S. Levey, MDTufts Medical Center, Boston, Massachusetts (N.G., D.E.W., A.S.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3721 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The risk for kidney failure from lupus nephritis (LN) is high and has not changed in the past 20 years despite advances in diagnostic and treatment options for systemic lupus erythematosus. The United States Renal Data System collects data on all U.S. patients who receive dialysis or a transplant to treat end-stage renal disease (ESRD) (1). Approximately 2% of the U.S. dialysis population has ESRD due to LN (1).In the early years of kidney transplantation, patients with LN were not considered acceptable recipients because of concern about recurrent disease and accelerated rejection. Many studies have since demonstrated satisfactory outcomes, ...References1. Saran R, Robinson B, Abbott KC, Agodoa LYC, Bhave N, Bragg-Gresham J, et al. US renal data system 2017 annual data report: epidemiology of kidney disease in the United States [Editorial]. Am J Kidney Dis. 2018;71:A7. [PMID: 29477157] doi:10.1053/j.ajkd.2018.01.002 CrossrefMedlineGoogle Scholar2. Lionaki S, Skalioti C, Boletis JN. Kidney transplantation in patients with systemic lupus erythematosus. World J Transplant. 2014;4:176-82. [PMID: 25346890] doi:10.5500/wjt.v4.i3.176 CrossrefMedlineGoogle Scholar3. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341:1725-30. [PMID: 10580071] CrossrefMedlineGoogle Scholar4. Jorge A, Wallace ZS, Lu N, Zhang Y, Choi HK. Renal transplantation and survival among patients with lupus nephritis. A cohort study. Ann Intern Med. 2019;170:240-7. doi:10.7326/M18-1570 LinkGoogle Scholar5. Grams ME, Massie AB, Schold JD, Chen BP, Segev DL. Trends in the inactive kidney transplant waitlist and implications for candidate survival. Am J Transplant. 2013;13:1012-8. [PMID: 23399028] doi:10.1111/ajt.12143 CrossrefMedlineGoogle Scholar6. Ward MM, Pyun E, Studenski S. Long-term survival in systemic lupus erythematosus. Patient characteristics associated with poorer outcomes. Arthritis Rheum. 1995;38:274-83. [PMID: 7848319] CrossrefMedlineGoogle Scholar7. Jay CL, Dean PG, Helmick RA, Stegall MD. Reassessing preemptive kidney transplantation in the United States: are we making progress? Transplantation. 2016;100:1120-7. [PMID: 26479285] doi:10.1097/TP.0000000000000944 CrossrefMedlineGoogle Scholar8. Naveed A, Nilubol C, Melancon JK, Girlanda R, Johnson L, Javaid B. Preemptive kidney transplantation in systemic lupus erythematosus. Transplant Proc. 2011;43:3713-4. [PMID: 22172832] doi:10.1016/j.transproceed.2011.08.092 CrossrefMedlineGoogle Scholar9. Plantinga LC, Patzer RE, Drenkard C, Kramer MR, Klein M, Lim SS, et al. Association of time to kidney transplantation with graft failure among U.S. patients with end-stage renal disease due to lupus nephritis. Arthritis Care Res (Hoboken). 2015;67:571-81. [PMID: 25251922] doi:10.1002/acr.22482 CrossrefMedlineGoogle Scholar10. Contreras G, Mattiazzi A, Guerra G, Ortega LM, Tozman EC, Li H, et al. Recurrence of lupus nephritis after kidney transplantation. J Am Soc Nephrol. 2010;21:1200-7. [PMID: 20488956] doi:10.1681/ASN.2009101093 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Tufts Medical Center, Boston, Massachusetts (N.G., D.E.W., A.S.L.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3721.Corresponding Author: Nitender Goyal, MD, 800 Washington Street, Box 391, Boston, MA 02111; e-mail, [email protected]org.Current Author Addresses: Drs. Goyal, Weiner, and Levey: 800 Washington Street, Box 391, Boston, MA 02111.This article was published at Annals.org on 22 January 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRenal Transplantation and Survival Among Patients With Lupus Nephritis April Jorge , Zachary S. Wallace , Na Lu , Yuqing Zhang , and Hyon K. Choi Metrics 19 February 2019Volume 170, Issue 4Page: 266-267KeywordsLupus erythematosusLupus nephritisMedical dialysisRenal failureRenal systemRenal transplantationResearch designSocioeconomic statusSurvival analysisTransplantation ePublished: 22 January 2019 Issue Published: 19 February 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...