Systemic lupus erythematosus: analysis of disease activity in 55 patients with end-stage renal failure treated with hemodialysis or continuous ambulatory peritoneal dialysis
Article Abstract:
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of connective tissue and may be complicated by renal or kidney disease in 50 to 80 percent of patients. Twenty percent of patients with lupus nephritis (LN), the inflammation of the kidney associated with SLE, develop end-stage (advanced) kidney failure within 10 years after the diagnosis of LN and require dialysis, the artificial filtration of the blood to remove wastes. In hemodialysis, the blood is filtered through tubes made of membranes that selectively filter and remove unwanted wastes. Continuous ambulatory peritoneal dialysis (CAPD) is a form of dialysis in which a catheter is implanted into the peritoneal (abdominal) cavity. Some studies have suggested that disease activity in SLE is worsened by CAPD. Hence the disease activity in 55 patients with SLE was assessed before and after advanced kidney failure, during hemodialysis and CAPD. Kidney function slowly deteriorated over more than two years in most patients. SLE disease activity and the use of medications decreased after the start of dialysis to treat kidney disease. However, dialysis did not improve the incidence of non-kidney-related complications of SLE. Eighty-nine percent of patients with SLE undergoing dialysis were surviving at five years. Disease activity and use of medications were similar among patients treated with hemodialysis or CAPD. However, patients treated with CAPD had a greater incidence of thrombocytopenia, which is a decreased number of platelets (cells involved in blood clotting), and of antibodies to deoxyribonucleic acid (DNA), the genetic material of the cell. These findings show that dialysis improves survival among patients with SLE, and inhibits but does not abolish disease activity. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Association of psychiatric manifestations with antibodies to ribosomal P proteins in systemic lupus erythematous
Article Abstract:
Systemic lupus erythematous (SLE) is a connective tissue disease characterized by the presence of inflammation, skin lesions, and joint pain. In some cases, patients with SLE experience psychiatric disorders such as depression and psychosis. In SLE, the body may make antibodies that attack ribosome type P proteins (ribosomes are the structures inside a cell that make proteins.) These antibodies are called anti-P antibodies. The relationship between the presence of serum anti-P antibodies and psychiatric symptoms was evaluated in patients with and without SLE. In 79 normal control subjects and in 21 patients with rheumatoid arthritis, the serum levels of anti-P antibody were negligible. Twenty-seven out of 187 patients (14 percent) with SLE, but without psychiatric symptoms, had elevated serum levels of anti-P antibody. Twenty-four out of 82 patients (29 percent) with SLE and psychiatric symptoms had elevated serum levels of anti-P antibodies. The difference in serum anti-P antibody levels between these two groups was not statistically significant. However, when the psychiatric disorders were subdivided based on the presence of severe depression or a general psychosis, the results were significant. Elevated serum anti-P antibodies were found in 7 out of 8 patients (88 percent) with severe depression, and in 13 out of 29 patients (45 percent) with psychosis. It is concluded that an elevated serum anti-P antibody level is a specific marker for SLE, and that serum anti-P antibodies are associated with severe depression and psychosis in patients with SLE. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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