ESRD attributed to | ||||
---|---|---|---|---|
Characteristic | Overall | SLE | Other | p Value* |
Sociodemographics | ||||
Age in years at SLE diagnosis, mean (SD) | 25.3 (13.6) | 21.9 (11.2) | 38.2 (14.3) | <0.001 |
Age (years) at SLE diagnosis, no (%) | <0.001 | |||
<18 | 82 (32.7%) | 77 (38.9%) | 4 (9.4%) | |
18–30 | 91 (36.3%) | 80 (40.4%) | 11 (20.8%) | |
>30 | 78 (31.1%) | 41 (20.7%) | 37 (69.8%) | |
Sex, no (%) | 0.66 | |||
Male | 38 (15.1%) | 31 (15.7%) | 7 (13.2%) | |
Female | 213 (84.9%) | 167 (84.3%) | 46 (86.8%) | |
Race, no (%) | 0.64 | |||
Black | 232 (92.4%) | 184 (92.9%) | 48 (90.6%) | |
White | 18 (7.2%) | 13 (6.6%) | 5 (9.4%) | |
Asian | 1 (0.4%) | 1 (0.5%) | 0 (0.0%) | |
Hispanic, no (%) | ||||
Yes | 3 (1.2%) | 3 (1.5%) | 0 (0.0%) | >0.9 |
No | 247 (98.8%) | 194 (98.5%) | 53 (100.0%) | |
% black residents in residential census tract, median (IQR) | 89.1 (73.7–95.5) | 88.8 (73.7–95.3) | 89.6 (77.7–96.3) | 0.46 |
% living below poverty in residential census tract, median (IQR) | 11.2 (7.0–22.7) | 10.8 (6.5–22.5) | 12.0 (7.9–24.5) | 0.27 |
% high-school dropouts in residential census tract, median (IQR) | 13.3 (8.5–25.8) | 13.2 (8.4–24.4) | 14.8 (9.6–26.6) | 0.27 |
Access to care | ||||
Insurance† at start of ESRD, no (%) | 0.02 | |||
Private | 91 (39.7%) | 66 (36.5%) | 25 (52.1%) | |
Medicaid | 65 (28.4%) | 56 (30.9%) | 9 (18.8%) | |
Other | 42 (18.3%) | 30 (16.6%) | 12 (25.0%) | |
None | 31 (13.5%) | 29 (16.0%) | 2 (4.2%) | |
Pre-ESRD nephrology care, no (%) | 0.09 | |||
Yes | 77 (77.0%) | 56 (72.7%) | 21 (91.3%) | |
No | 23 (23.0%) | 21 (27.3%) | 2 (8.7%) | |
Physician stating final diagnosis, no (%) | 0.005 | |||
No rheumatologist, dermatologist or nephrologist | 33 (13.2%) | 20 (10.2%) | 13 (24.5%) | |
Rheumatologist | 83 (33.2%) | 61 (31.0%) | 22 (41.5%) | |
Dermatologist | 4 (1.6%) | 3 (1.5%) | 1 (1.9%) | |
Nephrologist | 39 (15.6%) | 32 (16.2%) | 7 (13.2%) | |
Combination of rheumatologist, dermatologist or nephrologist | 91 (36.4%) | 8 (41.1%) | 10 (18.9%) | |
At least one renal biopsy, no (%) | 0.13 | |||
Yes | 173 (68.9%) | 141 (71.2%) | 32 (60.4%) | |
No | 78 (31.1%) | 57 (28.8%) | 21 (39.6%) | |
Multiple renal biopsies, no (%) | 0.16 | |||
Yes | 82 (32.7%) | 69 (34.9%) | 13 (24.5%) | |
No | 169 (67.3%) | 129 (65.1%) | 40 (75.5%) | |
Clinical | ||||
Duration of SLE prior to ESRD start, years | 8.0 (4.0–14.1) | 8.0 (4.1–13.6) | 9.0 (4.0–16.3) | 0.47 |
Duration of SLE prior to ESRD start (years), no (%) | 0.74 | |||
<5 | 80 (31.9%) | 64 (32.3%) | 16 (30.2%) | |
5–10 | 64 (25.5%) | 52 (26.3%) | 12 (22.6%) | |
>10 | 107 (42.6%) | 82 (41.4%) | 25 (47.2%) | |
Physician-stated diagnosis, no (%) | <0.001 | |||
SLE | 219 (88.3%) | 184 (93.4%) | 35 (68.6%) | |
SLE and connective tissue disease | 22 (8.9%) | 10 (5.1%) | 12 (23.5%) | |
Drug-induced lupus | 1 (0.4%) | 0 (0.0%) | 1 (2.0%) | |
Specified connective tissue disease | 5 (2.0%) | 3 (5.9%) | 2 (1.0%) | |
Unspecified diffuse connective tissue disease | 1 (0.4%) | 1 (0.5%) | 0 (0.0%) | |
No of ACR criteria, median (IQR) | 5 (4–7) | 6 (4–7) | 5 (3–5) | <0.001 |
ACR criteria, % | 0.08 | |||
≥4 criteria | 193 (76.9%) | 157 (79.3%) | 36 (67.9%) | |
<3 criteria | 58 (23.1%) | 41 (20.7%) | 17 (32.1%) | |
ACR criterion present, no (%) | ||||
Malar rash | 72 (28.7%) | 63 (31.8%) | 9 (17.0%) | 0.03 |
Discoid rash | 35 (13.9%) | 29 (14.7%) | 6 (11.3%) | 0.54 |
Photosensitivity | 47 (18.7%) | 42 (21.2%) | 5 (9.4%) | 0.07 |
Mucocutaneous ulcers | 43 (17.1%) | 37 (18.7%) | 6 (11.3%) | 0.21 |
Arthritis | 161 (64.1%) | 136 (68.7%) | 24 (47.2%) | 0.004 |
Serositis | 119 (47.4%) | 99 (50.0%) | 20 (37.7%) | 0.11 |
Renal | 241 (96.0%) | 190 (96.0%) | 51 (96.2%) | >0.9 |
Neurological | 59 (23.9%) | 51 (25.8%) | 8 (15.1%) | 0.10 |
Haematological | 231 (92.0%) | 188 (95.0%) | 43 (81.1%) | 0.001 |
Immunological | 184 (73.3%) | 158 (79.8%) | 26 (49.1%) | <0.001 |
ANA | 206 (94.9%) | 162 (95.3%) | 44 (93.6%) | 0.71 |
Year of ESRD start, no (%) | 0.80 | |||
Before 1995 | 27 (10.8%) | 22 (11.1%) | 5 (9.4%) | |
1995–2004 | 120 (47.9%) | 96 (48.5%) | 24 (45.3%) | |
2005 or later | 104 (41.4%) | 80 (40.4%) | 24 (45.3%) |
n=251 for all characteristics except: Hispanic ethnicity, n=250; census tract characteristics, n=230; insurance at start of ESRD, n=229; pre-ESRD nephrology care, n=100 (collected 2005+ only); final physician stating diagnosis, n=250; physician-stated diagnosis, n=248.
*By t, rank-sum, χ2 or Fisher's exact test, as appropriate.
†Other insurance includes Medicare, VA and other coverage not listed.
ACR, American College of Rheumatology; CMS-2728, Centers for Medicare & Medicaid Services ESRD Medical Eligibility Form 2728; ESRD, end-stage renal disease; SLE, systemic lupus erythematosus.