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Vol. 16. Núm. 5. P2.
Páginas 434-435 (Septiembre - Octubre 2020)
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Vol. 16. Núm. 5. P2.
Páginas 434-435 (Septiembre - Octubre 2020)
Letter to the Editor
DOI: 10.1016/j.reuma.2018.11.012
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Leonor A. Barile-Fabrisa,
Autor para correspondencia
barilita@yahoo.com

Corresponding author.
, Lilia Andrade Ortegab, Daniel Xibillé Friedmmanc
a Hospital Ángeles del Pedregal, Ciudad de México, Mexcio
b Centro Médico 20 de Noviembre, Ciudad de México, Mexico
c Secretaria de Salud del Estado Morelos, Cuernavaca, Morelos, Mexico
Contenido relaccionado
Reumatol Clin. 2020;16:433-410.1016/j.reuma.2018.07.011
Juan Manuel Mejia-Vilet, Javier Tejeda-Maldonado, Ricardo Correa-Rotter
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Dear Editors,

Regarding the comments made by Mejía-Vilet of the recommendations in the guidelines1 with respect to the substitution of renal function in patients who develop end-stage renal disease due to lupus nephritis we coincide, and this is stated in the document, that the best option is renal transplantation. The evidence shows that this intervention is superior to hemodialysis or peritoneal dialysis,2 providing the patient with a better opportunity for survival in the median and long term, as well as reducing comorbidities and increasing life expectancy.

Regarding the comparison between hemodialysis and peritoneal dialysis, as stated in this letter, published evidence has been contradictory and depends on the population, comorbidities,3 resources and quality or conditions of the procedures. Although we do recognize the evidence provided by Contreras et al.4 in the US population that did not show differences between both treatment modalities, the recommendation to prefer hemodialysis instead of peritoneal dialysis when possible was based, as stated in the document, on an albeit small study, but one that coincides with many of the characteristics in our clinical environment. We agree that the best option should in any case be individualized based on patient characteristics and resource availability.

Conflict of interests

The authors declare that they have no conflict of interest or have received sponsorship for the preparation of this letter.

References
[1]
D. Xibillé-Friedmann, M. Pérez-Rodríguez, S. Carrillo-Vázquez, et al.
Guía de práctica clínica para el manejo del lupus eritematoso sistémico propuesta por el Colegio Mexicano de Reumatología.
[2]
M.G. Tektonidou, A. Dasgupta, M.M. Ward.
Risk of end-stage renal disease in patients with lupus nephritis, 1971–2015. A systematic review and Bayesian meta-analysis.
Arthritis Rheumatol, 68 (2016), pp. 1432-1441
[3]
G. Contreras, J. Pagan, R. Chokshi, et al.
Comparison of mortality of ESRD patients with lupus by initial dialysis modality.
Clin J Am Soc Nephrol, 9 (2014), pp. 1949-1956
[4]
C.-H. Weng, C.W. Hsu, C.C. Yu, et al.
Peritoneal dialysis and hemodialysis in systemic lupus erythematosus patients: comparison of clinical outcomes.
Kidney Blood Press Res, 32 (2009), pp. 451-456
Copyright © 2019. Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
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