Comparison of vascular access outcomes in patients with end-stage renal disease attributed to systemic lupus erythematosus vs. other causes: a retrospective cohort study

Plantinga, Laura C.; Lim, S. Sam; Patzer, Rachel E.; Pastan, Stephen O.; Drenkard, Cristina

doi:10.1186/s12882-016-0274-y

Table 5 Association of loss of vascular access patency^a with attribution of ESRD to SLE vs. other causes, among 2010 U.S. incident hemodialysis patients who started dialysis with a permanent vascular access: sensitivity analyses

From: Comparison of vascular access outcomes in patients with end-stage renal disease attributed to systemic lupus erythematosus vs. other causes: a retrospective cohort study

Model	No. (%) with access revision within 1 year	Hazard ratio (95 % CI) for loss of patency, SLE-attributed vs. other ESRD
Model	No. (%) with access revision within 1 year	Unadjusted	Adjusted for demographics	Adjusted for demographics + clinical
Primary analysis
SLE-attributed ESRD	21 (43.8 %)	0.70 (0.45-1.09)	0.81 (0.52-1.26)	0.88 (0.57-1.37)
Other ESRD	7,169 (55.0 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	0.12	0.11	0.35	0.58
Excluding patients <18 years old^b
SLE-attributed ESRD	21 (43.8 %)	0.70 (0.45-1.08)	0.81 (0.52-1.26)	0.88 (0.57-1.37)
Other ESRD	7,165 (55.1 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	0.12	0.11	0.35	0.57
Only among patients with Medicare at ESRD start^c
SLE-attributed ESRD	---^d	0.91 (0.55-1.52)	0.86 (0.52-1.42)	0.92 (0.55-1.53)
Other ESRD	1125 (13.0 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	0.76	0.73	0.55	0.75
SLE and other GN compared to other ESRD^e
SLE-attributed ESRD	---^d	0.69 (0.44-1.07)	0.80 (0.52-1.24)	0.87 (0.56-1.35)
Other GN-attributed ESRD	60 (6.9 %)	0.79 (0.71-0.88)	0.87 (0.78-0.96)	0.91 (0.82-1.02)
Other ESRD	1433 (11.8 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	<0.001	0.10/<0.001	0.32/0.008	0.54/0.09
Matched analysis^f
SLE-attributed ESRD	21 (43.8 %)	0.71 (0.42-1.19)	0.70 (0.42-1.15)	0.81 (0.47-1.40)
Other ESRD	89 (58.2 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	0.08	0.19	0.16	0.46
Events prior to 90 days included on day 91
SLE-attributed ESRD	21 (43.8 %)	0.73 (0.47-1.13)	0.81 (0.52-1.27)	0.88 (0.57-1.37)
Other ESRD	7,169 (55.0 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	0.12	0.16	0.36	0.57
Events prior to 90 days excluded^g
SLE-attributed ESRD	13 (32.5 %)	0.85 (0.49-1.46)	0.76 (0.44-1.31)	0.84 (0.48-1.45)
Other ESRD	3,377 (36.6 %)	1.00 (ref.)	1.00 (ref.)	1.00 (ref.)
P	0.59	0.56	0.32	0.52

AVF arteriovenous fistula, AVG arteriovenous graft, ESRD end-stage renal disease, GN glomerulonephritis, SLE systemic lupus eythematosus. Demographics: age (continuous), sex, race; clinical: body mass index (continuous), smoking, congestive heart failure, diabetes, and peripheral vascular disease
^aDefined as a revision or placement of a new AVF, AVG, or catheter (see Table 1)
^bExcluding n = 14 patients (4 SLE, 10 other) who were <18 years old
^cExcluding n = 4,375 patients (23 SLE, 4,352 other) without Medicare at ESRD start
^dNot reportable due to cell size < 10
^eOther GN included 864 patients with CMS-2728 ICD-9 codes for attributed cause of glomerulonephritis (582.9, 582.1, 583.1, 583.21, 583.22, 583.81, 583.82, 583.4, 580.0, and 582.0) or secondary glomerulonephritis/vasculitis (excluding SLE-ESRD; 287.0, 710.1, 283.11, 446.0, 446.4, 583.92, 446.20, 446.21, and 583.91)
^fAmong n = 201 patients, including 48 SLE patients and 153 matched non-SLE patients, using 2:1 matching on age group (<30, 30–49, and >50 years), sex (female and male), and race (black and not black). Models stratified on matching variable to account for matching
^gExcluding n = 3,801 patients (35 SLE, 8,456 other) with follow-up time <90 days

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