A comparison of the quality of life of patients with systemic lupus erythematosus with and without endstage renal disease.

OBJECTIVE: To compare health related quality of life between patients with lupus nephritis who progressed to endstage renal disease (ESRD) and patients with systemic lupus erythematosus (SLE) with preserved renal function.

METHODS: Patients with SLE undergoing maintenance renal dialysis and SLE patients with preserved renal function completed the Medical Outcomes Study Short Form-36 and social support questionnaires and the Center for Epidemiologic Studies Depression Scale. SLE disease activity and organ damage were measured by the SLE Disease Activity Index and Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index.

RESULTS: We studied 104 patients with SLE: 22 undergoing maintenance renal dialysis and 82 with preserved renal function. Their scores in all 8 of the SF-36 scales were reduced compared to national norms. Patients with ESRD had significantly higher mental health scores (mean +/- standard error 71.3 +/-4.8 vs. 60.7+/-2.5; p = 0.05), but there were no significant differences between the 2 groups in the remaining SF-36 scales. Multivariate models adjusting for demographic, socioeconomic, and clinical characteristics and for symptoms of depression revealed that being on dialysis was associated with higher mental health scores (regression coefficient = 12.97, 95% confidence interval 2.72 to 23.22), but lower physical function [-11.28 (-22.43 to -0.12)] and general health [-10.94 (-21.31 to -0.57)].

CONCLUSION: Patients with lupus nephritis who progress to endstage renal disease have improved mental well being but reduced physical function and general health. Strategies to improve the quality of life of patients with SLE are needed.