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THU0509 Chronic Kidney Disease Independently Predicts Cardiovascular Morbidities among Hospitalized Patients with Systemic Lupus Erythematosus: Findings from a United States National Study
  1. B. Mehta1,
  2. M. Mujib1,
  3. N. K. Mazumder2,
  4. C. Palaniswamy1,3,
  5. S. Khera1,
  6. D. Kolte1,
  7. I. Tassiulas1,4,
  8. W. S. Aronow1,3
  1. 1Internal Medicine, Westchester Medical Center at New York Medical College, Valhalla
  2. 2Medicine, Medical University of the Americas, Devens
  3. 3Cardiology
  4. 4Rheumatology, Westchester Medical Center at New York Medical College, Valhalla, United States

Abstract

Background Glomerulonephritis leading to chronic kidney disease (CKD) is a major cause of morbidity in systemic lupus erythematosus (SLE). Accelerated atherosclerosis has been recognized as the major underlying factor of the early cardiovascular mortality in SLE.

Objectives To investigate the associations of CKD and cardiovascular morbidities and inpatient mortality in patients with SLE from a large nationwide hospital registry database

Methods All hospitalized patients aged between 18 to 65 years included in the nationwide inpatient sample (NIS) 2010 database with a confirmed discharge diagnosis of SLE, as per the ICD-9-CM code 710.0 were identified. NIS is the largest all-payer inpatient care database in the United States. Multivariable logistic regression models were used to determine the associations of CKD with congestive heart failure (CHF) and CKD with acute myocardial infarction (AMI) among these patients. Multivariable Cox proportional survival analyses were used to determine the association of CKD and in-hospital mortality.

Results From 7,800,441 hospitalizations in NIS 2010 database, 28,175 SLE patients were identified. Patients had a mean age of 45 (±13) years, 90% (25,282) were women and 57% (16,186) were non-whites. CHF was prevalent in 8.6% (2302/26889) and 22.4% (288/1286) of patients without and with CKD, respectively (adjusted odds ratio for CHF comparing those without and with CKD, 2.27; 95% confidence interval {CI}, 1.96–2.64; p<0.001). AMI occurred in 1.3% (360/26889) and 3.0% (38/1286) of patients without and with CKD, respectively (adjusted odds ratio, 1.53; 95% confidence interval, 1.06–2.20; p=0.023). CKD was not associated with in-hospital mortality among hospitalized SLE patients (Table 1).

Conclusions In this large national database, CKD was independently associated with AMI and CHF among hospitalized SLE patients. However inpatient mortality was not increased. Further prospective studies are needed to understand this relationship in this high-risk population.

Disclosure of Interest None Declared

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