Impact of Lupus on All‐Cause, Cardiovascular, and Infection‐Related Mortality Among Dialysis Patients: Okinawa Dialysis Study Registry

INTRODUCTION: Lupus nephritis is one of the most serious complications of systemic lupus erythematosus (SLE) and can lead to end-stage kidney disease (ESKD). We aimed to assess the relative mortality risk associated with SLE among dialysis patients. METHODS: This retrospective longitudinal cohort study included all dialysis patients in the Okinawa Dialysis Study 30 registry. Cox proportional hazard models were performed to assess mortality. RESULTS: Of 5246 patients, 111 had ESKD secondary to SLE. Compared with ESKD patients secondary to other causes, those with SLE had significantly higher risk of death (HR 2.55, 95% CI 1.81-3.47, p < 0.0001), cardiovascular death (HR 1.94, 95% CI 1.13-3.33, p = 0.0158), and infection death (HR 4.21, 95% CI 2.40-7.37, p < 0.0001) after adjusting for age, era of dialysis initiation, and sex. CONCLUSION: SLE may be independently associated with an increased risk of death in dialysis patients.