@article{5333f7f31e874883a824bd6dbe6a478a,
title = "Infection-related hospitalization and risk of end-stage renal disease in patients with systemic lupus erythematosus: A nationwide population-based study",
abstract = "Background Infections are a major cause of morbidity in patients with systemic lupus erythematosus (SLE), and may lead to death. No nationally representative study of patients with SLE has examined the rates of infection-related hospitalization and the risk of end-stage renal disease (ESRD). Methods We conducted a nationwide cohort study of 7326 patients with newly diagnosed SLE and no history of ESRD. All data were from Taiwan's National Health Insurance claims database for the period 2000-11. Results Among all SLE patients, 316 (4.3%) developed ESRD (mean follow-up time: 8.1 years). Multivariate Cox regression analysis indicated that the risk of ESRD increased with the number of infection-related hospitalizations. For patients with three or more infection-related admissions, the hazard ratio (HR) for ESRD was 5.08 [95% confidence interval (CI): 3.74-6.90] relative to those with no infection-related admission. Analysis by type of infection indicated that bacteremia patients had the greatest risk for ESRD (HR: 4.82; 95% CI: 3.40-6.85). Analysis of age of SLE onset indicated that patients with juvenile-onset (<18 years) and three or more infection-related hospitalizations had a greatly increased risk for ESRD (HR: 14.49; 95% CI: 5.34-39.33). Conclusions Infection-related hospitalizations are associated with a significantly increased risk of ESRD in patients with SLE, especially those with juvenile-onset SLE. Among patients with different types of infectious diseases, those with bacteremia were more likely to develop ESRD.",
author = "Lin, {Chien Hung} and Hung, {Peir Haur} and Hu, {Hsiao Yun} and Chen, {Yann Jang} and Guo, {How Ran} and Hung, {Kuan Yu}",
note = "Funding Information: 1Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, 2Department of Pediatrics, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan,3Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi, Taiwan, 4Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan, 5Department of Education and Research, Taipei City Hospital, Taipei, Taiwan, 6Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, 7Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 8Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan and 9Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan Funding Information: This study is based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and managed by the National Health Research Institutes. The interpretations and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health or the National Health Research Institutes. Publisher Copyright: {\textcopyright} The Authors 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.",
year = "2017",
month = oct,
day = "1",
doi = "10.1093/ndt/gfw407",
language = "English",
volume = "32",
pages = "1683--1690",
journal = "Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "10",
}