Poor Prognosis in End-Stage Lupus Nephritis due to Nonautologous Vascular Access Site Associated Septicemia and Lupus Flares
作者:
Richard L. Sires,
Sharon G. Adler,
James S. Louie,
Arthur H. Cohen,
期刊:
American Journal of Nephrology
(Karger Available online 1989)
卷期:
Volume 9,
issue 4
页码: 279-284
ISSN:0250-8095
年代: 1989
DOI:10.1159/000167981
出版商: S. Karger AG
关键词: Systemic lupus erythematosus;Hemodialysis;End-stage renal disease;Lupus flares;Vascular access site
数据来源: Karger
摘要:
A poor prognosis was observed in patients who had end-stage renal disease (ESRD) as a result of systemic lupus erythematosus (SLE). This was true even in patients in whom SLE disease activity was transiently quiescent during the period of hemodialysis. Six of 9 patients with ESRD and SLE died with active SLE and/or sepsis 1–28 months following the onset of dialysis. In 5 of the 6 patients, acute inflammatory activity of SLE flared within 1 month of the patient’s death. Four patients died with superimposed sepsis, but only 2 of the 4 were receiving high-dose concomitant immunosuppressives for more than 1 week prior to death. Infected hemodialysis vascular access sites were implicated as the source of septicemia in 3 of 4 infectious deaths. The 3 surviving patients had minimal lupus activity prior to the development of ESRD, a possible marker for stability in SLE patients who require hemodialysis. Our results suggest that hemodialyzed lupus patients with nonautologous vascular access sites may be at continued increased risk for life-threatening inflammatory and septic complicati
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