November 1, 2009
Kidney Transplants Safe For Lupus Patients
Contrary to previous studies, lupus patients who receive kidney transplants rarely develop lupus nephritis
Individuals with a history of lupus who receive a kidney transplant rarely develop the serious inflammatory condition lupus nephritis in their new organ, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA. The findings indicate that having lupus should not keep individuals from seeking a kidney transplant if they need one.Individuals with the autoimmune disease systemic lupus erythematosus (lupus) can experience a number of medical complications, such as lupus nephritis, an inflammatory kidney disorder. Previous studies provide conflicting results about the incidence and severity of lupus nephritis in patients with a history of lupus who have undergone a kidney transplant. Some studies conclude that lupus nephritis is of little consequence while others report that the condition can increase the risk of kidney failure and the risk of death in recipients of a kidney transplant.
Gabriel Contreras, MD, MPH (University of Miami), and his colleagues conducted a thorough evaluation of the frequency of lupus nephritis in kidney transplant recipients and determined the risk this condition has for patients. They mined data from the United Network for Organ Sharing and studied 6850 patients with a history of lupus who received kidney transplants between 1987 and 2006.
The researchers found that lupus nephritis rarely developed in the transplanted kidneys of these lupus patients; it occurred in 2.44% of individuals in the study. When it did occur, lupus nephritis led to a 4-fold increased relative risk of kidney transplant failure; however, the overall risk for the loss of the new organ attributed to lupus developing in the transplanted kidneys was only 7%. During the study period of 19 years, 12.7% of patients died with only 0.4% patients dying in the group with lupus developing in the transplanted kidneys. The investigators also found that African Americans and young women were at higher risk for developing lupus nephritis in their transplanted kidney. Receiving a kidney transplant before or after starting dialysis did not affect one's risk. The type of kidney transplant (deceased vs living donor) also had no effect on a recipient's risk of developing lupus nephritis.
The authors report no financial disclosures. Study co-authors include Baudouin LeClercq (private practice) and Adela. Mattiazzi, Giselle Guerra, Hua Li, Leonardo Tamariz, Cristiane Carvalho, Warren Kupin, Isabel Jaraba, Decio Carvalho, Marco Ladino, and David Roth (University of Miami).
The study abstract, "Recurrence of Lupus Nephritis Following Kidney Transplantation," (SA-PO3076) was presented as part of a Poster Session during the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition on Oct. 31.
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