Incidence, prevalence of lupus nephritis increased in Minnesota since 1976
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In the 4 decades since 1976, the incidence and prevalence of lupus nephritis has increased among the population in Minnesota, according to data published in Arthritis Rheumatology.
Further, patients with lupus nephritis (LN) have high rates of end-stage kidney disease and a mortality ratio that is six times higher than the general population.
“Given the fragmentation of the U.S. health care system, it is difficult to estimate the incidence and prevalence of LN in the general population,” Mehmet Hocaoglu, MD, from the division of rheumatology at the Mayo Clinic in Rochester Minnesota, and colleagues wrote. They added, “In this population-based study of LN in the U.S., we aimed to characterize the incidence, prevalence, renal outcomes and mortality of LN in an eight-county region of Minnesota.”
The Minnesota counties studied include Olmsted, Mower, Freeborn, Waseca, Steele, Dodge, Wabasha and Goodhue.
Researchers examined 72 patients with LN (mean age was 38.4 years; 76% were women) between 1976 and 2018 using data from the Lupus Midwest Network, a population-based lupus registry funded by the CDC.
Adjusting to the projected U.S. population in 2000, researchers identified age- and sex-specific incidence rates and point prevalence for 4 decades. Further, researchers estimated standardized mortality ratios, survival rates and time to EDSK among patients.
Using Kaplan-Meier methods, researchers estimated survival rates following LN diagnoses and compared these to expected survival of the Minnesota population.
A total of 72 incident LN cases occurred between Jan. 1, 1976, and Dec. 31, 2018, in the observed area of Minnesota. The average annual LN incidence was 1 per 100,000 population, and LN was most likely to occur in patients aged between 30 and 39 years. Between 1976 to 1989 and 2000 to 2018, researchers observed an increase of overall LN incidence from 0.7 to 1.3 per 100,000. While this increase was not statistically significant, the estimated LN prevalence from 1985 to 2015 increased from 16.8 to 21.2 per 100,000.
Additionally, the standardized mortality ratio of LN was 6.33, and there was no improvement in the mortality gap during the study. Researchers noted that the survival was 70% at 10 years.
“Our results regarding mortality demonstrated that LN patients had six times the mortality of the general population, and the mortality gap has not improved in the last 40 years. In our LN cohort, 13% of patients developed ESRD; only 61% were alive and did not have ESKD or renal transplant at 10 years of follow-up,” Hocaoglu and colleagues wrote. “Among the CDC-funded lupus registries, this study provides incidence and standardized mortality rate estimates and its secular trends data specifically for LN.”
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