Recent prognosis of female patients with ESKD secondary to lupus

Abstract Background Systemic lupus erythematosus (SLE) predominantly affects young women. With advances in lupus nephritis treatment, the incidence of end-stage kidney disease has reduced. However, few studies have examined the long-term prognosis of patients with SLE after the initiation of maintenance dialysis. Therefore, this study aimed to evaluate the impact of SLE on mortality among female patients on maintenance dialysis in Japan. Methods Data were analyzed from the Web-Based Analysis of Dialysis Data Archives system provided by the Japanese Society for Dialysis Therapy. This study included female patients on dialysis registered between 2017 and 2023. Patients were divided into two age groups (< 60 years and ≥ 60 years). Relative risks (RRs) with 95% confidence intervals (CIs) were obtained with reference to patients without SLE on dialysis. Results The average annual number of patients was approximately 112,658/SLE 886. The mortality risk among patients aged < 60 years was not significantly different between those with and without SLE from 2017 to 2019, but became significantly higher in patients with SLE than in non-SLE patients from 2020 to 2023 (RR: 1.76, 95% CI: 1.11–2.80, p = 0.0151 in 2020; RR: 1.91, 95% CI: 1.22–3.00, p = 0.0042 in 2021; RR: 2.50, 95% CI: 1.69–3.70, p < 0.001 in 2022; RR: 1.72, 95% CI: 1.07–2.76, p = 0.0246 in 2023). In contrast, no significant difference was observed among those aged ≥ 60 years. Conclusions This study showed an increased risk of all-cause mortality among female patients under 60 years of age with SLE undergoing dialysis since 2020 in Japan.