Evidence map›Paper›PMID 41294263›Full record

ReviewACR open rheumatology2025

Renal Replacement Therapy in Lupus Nephritis-Related End-Stage Kidney Disease: A Systematic Review and Meta-Analysis.

Hassan Kawtharany, April Jorge, Muayad Azzam, Christie M Bartels, Joanne S Cunha, Kimberly DeQuattro, Andrea Fava, Gabriel Figueroa-Parra, Shivani Garg, Jessica Greco and 22 more

Abstract readReview
In one paragraph

Review in ACR open rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Hassan KawtharanyUniversity of Kansas, Kansas City.
April JorgeMassachusetts General Hospital, Boston.ORCID https://orcid.org/0000-0001-6935-880X
Muayad AzzamUniversity of Kansas, Kansas City.
Christie M BartelsUniversity of Wisconsin, Madison.ORCID https://orcid.org/0000-0001-6523-0374
Joanne S CunhaWarren Alpert Medical School of Brown University, Providence, Rhode, Island.
Kimberly DeQuattroUniversity of Pennsylvania, Philadelphia.ORCID https://orcid.org/0000-0001-8339-5666
Andrea FavaJohns Hopkins University, Baltimore, Maryland.ORCID https://orcid.org/0000-0001-6738-4836
Gabriel Figueroa-ParraMayo Clinic, Rochester, Minnesota, and University Hospital "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico.ORCID https://orcid.org/0000-0002-6077-8899
Shivani GargUniversity of Wisconsin, Madison.ORCID https://orcid.org/0000-0001-7272-2692
Jessica GrecoThe Ohio State University Wexner Medical Center, Columbus.
Maria C Cuéllar-GutiérrezMayo Clinic, Rochester, Minnesota, and Hospital del Salvador, Santiago, Chile.
Priyanka IyerUniversity of California Irvine Medical Center, Orange.
Andrew S JohannemannCarolina Arthritis Center, Greenville, North Carolina.
Shanthini KasturiTufts Medical Center, Boston, Massachusetts.
Jana KhawandiUniversity of Kansas, Kansas City.
Kyriakos A KirouHospital for Special Surgery - Weill Cornell Medicine, New York, New York.ORCID https://orcid.org/0000-0003-2781-0065
Alexandra LeggeDalhousie University, Halifax, Nova Scotia, Canada.
Kelly V LiangUniversity of Kansas, Kansas City.
Megan M LockwoodGeorgetown University Hospital, Washington, District of Columbia.ORCID https://orcid.org/0000-0001-8863-219X
Alain Sanchez-RodriguezMayo Clinic, Rochester, Minnesota, and Internal Medicine Department, Private Assistance Institution, The American British Cowdray Medical Center, Mexico City, Mexico.ORCID https://orcid.org/0000-0001-5758-0542
Marat TurgunbaevAmerican College of Rheumatology, Atlanta, Georgia.
Jessica N WilliamsWashington University, St. Louis, Missouri.ORCID https://orcid.org/0000-0002-1134-9625
Lisa R SammaritanoHospital for Special Surgery - Weill Cornell Medicine, New York, New York.ORCID https://orcid.org/0000-0003-2387-5363
Anca AskanaseColumbia University, New York, New York.ORCID https://orcid.org/0000-0003-4597-5023
Bonnie L BermasUniversity of Texas Southwestern Medical Center, Dallas.ORCID https://orcid.org/0000-0002-1007-4084
Maria Dall'EraUniversity of California, San Francisco.
Alí Duarte-GarcíaMayo Clinic, Rochester, Minnesota.ORCID https://orcid.org/0000-0003-1749-5719
Linda T HirakiThe Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-6690-8148
Brad RovinThe Ohio State University, Columbus.ORCID https://orcid.org/0000-0001-5639-0210
Mary Beth F SonBoston Children's Hospital, Boston, Massachusetts.
Amy S TurnerAmerican College of Rheumatology, Atlanta, Georgia.ORCID https://orcid.org/0000-0001-7695-2022
Reem A MustafaUniversity of Kansas, Kansas City.ORCID https://orcid.org/0000-0002-2091-0875

Funding

Early and Personalized Cardiovascular Disease Preventive Care in Lupus Nephritis (EPiC-LN)K23AR084608 · NIAMS · YALE UNIVERSITY · PI SHIVANI GARG · 2024 to 2026
$512k
American college of RheumatologyNIAMS NIH HHS K23 AR084608
6 · The paper itself

Abstract

objectiveTo assess the impact of renal replacement therapy in people with lupus nephritis (LN)-associated end-stage kidney disease (ESKD) and support the development of the 2024 American College of Rheumatology LN treatment guidelines.

methodsWe conducted a systematic literature review and meta-analysis to address three Population, Intervention, Comparison, and Outcome (PICO) questions related to renal replacement therapy for ESKD due to LN, including comparisons of kidney transplant versus dialysis, hemodialysis versus peritoneal dialysis, and preemptive kidney transplant versus no preemptive kidney transplant. Outcomes of interest included mortality, cardiovascular (CV) events, infections, lupus flares, disease-related damage, graft failure, and quality of life. We conducted a meta-analysis and analyzed hazard ratios for time-to-event analyses and risk ratios for dichotomous outcomes, as well as absolute risk estimates.

resultsSixteen comparative observational studies addressed at least one of the three PICO questions. Kidney transplant was found to reduce the risks of all-cause mortality, CV mortality, infection-related mortality, and CV events compared with dialysis (high certainty). Dialysis modality (peritoneal vs hemodialysis) was not associated with mortality (high certainty) or with other outcomes of infection, CV complications, and systemic lupus erythematosus flares (low certainty). Preemptive kidney transplant was associated with lower risks of graft failure and mortality (low certainty).

conclusionThis systematic review identified improved outcomes with kidney transplant versus dialysis for people with LN-associated ESKD and potential benefits of preemptive kidney transplant. This evidence supports the use of kidney transplant as a preferred renal replacement therapy for people with LN-ESKD.

Identifiers

PMID41294263
PMCPMC12648630

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.