Earlier Transplants for Patients with Lupus Nephritis–Associated End-Stage Renal Disease?

Among patients with end-stage renal disease (ESRD), renal transplants lower relative risk for ESRD-associated death by roughly 50%. However, some experts question transplantation in patients with ESRD caused by lupus nephritis because of concerns about infection risk (associated with required intensive immunosuppression), thrombosis (associated with antiphospholipid antibody syndrome), and recurrent allograft nephritis. To determine whether renal transplant confers a survival benefit in lupus patients with ESRD, researchers identified a retrospective U.S. cohort of 10,000 such patients who were waitlisted for renal transplant from 1995 to 2014, of whom ≈60% underwent transplantation.

By the end of the follow-up period (December 2015), mortal…