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Lupus Nephritis

Profound disparities in lupus nephritis mortality by race, urban residence

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There is higher mortality in patients with lupus nephritis (LN) who are non-white and those living in large central and medium metro areas, according to a presentation at the American College of Rheumatology Convergence 2021.

Overall, the mortality rate for LN has decreased since 1999, although data from 2015 to 2019 has shown an increasing trend. There were 8899 deaths attributed to LN from 1999 to 2019.

Over the 21-year study period, the overall LN- age-standardized mortality rate (ASMR) decreased by 26%. From 1999 to 2009 LN-ASMR decreased, before plateauing between 2009 and 2012 and decreasing again from 2012 to 2015. However, from 2015 to 2019 there was a significant increase in LN-ASMR.

Although only accounting for 12.8% of the US population, black persons accounted for 38% of LN deaths. White persons, who account for 65.4% of the US population, accounted for 41.5% of all LN deaths.

“LN-ASMR in black persons was 6-fold higher than in white persons and >2-fold higher than in all other race/ethnic groups,” the researchers noted.

People living in large central metro areas accounted for 35.1% of LN deaths although only 29.6% of the US population lives in these areas.

“Studies are urgently needed to understand reasons underlying these disparities and the recent worsening trend,”

Yen E, Rajkumar S, Sharma R, et al. Lupus Nephritis Mortality in the United States, 1999-2019: Profound Disparities by Race/Ethnicity and Place of Residence and a Recent Worsening Trend. Presented at: American College of Rheumatology (ACR) Convergence 2021.