Skip Navigation
Menu
Editorials |19 February 2019

Kidney Transplantation in Lupus Nephritis: Can We Do Even Better?

Nitender Goyal, MD; Daniel E. Weiner, MD, MS; Andrew S. Levey, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 22 January 2019.
×
FULL TEXT
The risk for kidney failure from lupus nephritis (LN) is high and has not changed in the past 20 years despite advances in diagnostic and treatment options for systemic lupus erythematosus. The United States Renal Data System collects data on all U.S. patients who receive dialysis or a transplant to treat end-stage renal disease (ESRD) (1). Approximately 2% of the U.S. dialysis population has ESRD due to LN (1).
In the early years of kidney transplantation, patients with LN were not considered acceptable recipients because of concern about recurrent disease and accelerated rejection. Many studies have since demonstrated satisfactory outcomes, and kidney transplant is now a well-established treatment option for patients with LN. However, concern remains that these patients may have increased risk for complications after transplant due to either ongoing immunologic activity, including thrombotic events, or complications related to pretransplant immunosuppressive therapy. Many providers suggest a waiting period while patients receive dialysis to allow immune activity to “burn out” before proceeding to transplant (2). Reports using data from the United States Renal Data System show a survival advantage of kidney transplant versus dialysis for patients healthy enough to be on the waitlist (3). However, these studies have not specifically evaluated the benefits of kidney transplant in patients with LN.
Jorge and colleagues (4) examined data from the United States Renal Data System between 1995 and 2014 to assess outcomes of patients with LN who initiated dialysis and were placed...
FULL TEXT
PDF
Not Available
Citations
Citation

Goyal N, Weiner DE, Levey AS. Kidney Transplantation in Lupus Nephritis: Can We Do Even Better?. Ann Intern Med. 2019;170:266–267. [Epub ahead of print 22 January 2019]. doi: 10.7326/M18-3721

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2019;170(4):266-267.

DOI: 10.7326/M18-3721

Published at www.annals.org on 22 January 2019

©
2019 American College of Physicians
0 Citations

Related Articles
Renal Transplantation and Survival Among Patients With Lupus Nephritis: A Cohort Study
Annals of Internal Medicine; 170 (4): 240-247
Kidney Transplants in Patients With Lupus Nephritis
Annals of Internal Medicine; 170 (4): I-32
Annals for Educators - 19 February 2019
Annals of Internal Medicine; 170 (4): ED4
Transplanting Hepatitis C Virus–Infected Versus Uninfected Kidneys Into Hepatitis C Virus–Infected Recipients: A Cost-Effectiveness Analysis
Annals of Internal Medicine; 169 (4): 214-223
View MoreView Less

Journal Club
Review: Steroid avoidance or withdrawal does not increase mortality or graft loss in kidney transplant patients
Annals of Internal Medicine; 151 (6): JC3-11
View MoreView Less

Related Point of Care
Systemic Lupus Erythematosus
Annals of Internal Medicine; 159 (7): ITC4-1
View MoreView Less

Related Topics
Autoimmune Kidney Disease
Lupus Erythematosus
Nephrology
Renal Replacement Therapy
Rheumatology

Autoimmune Kidney Disease, Lupus Erythematosus, Nephrology, Renal Replacement Therapy, Rheumatology.

PubMed Articles
Cost Analysis of Transfusion Therapy in Coronary Artery Surgery.
Thorac Cardiovasc Surg 2019.
An uncommon etiology of pancreatitis after endoscopic ultrasound-guided fine needle aspiration.
Endoscopy 2019.
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×