Chronic hemodialysis in end-stage lupus nephritis: changes of clinical and serological activities

The available data on the clinical and serological activities of systemic lupus erythematosus (SLE) in dialysis patients with end-stage lupus nephritis are limited. The clinical and serological parameters in 12 such patients prior to, at the onset of, and an average of 31 months after the institution of hemodialysis were retrospectively compared. One of the patients died of cardiopulmonary arrest within 1 week after institution of hemodialysis. All patients were clinically and serologically active prior to the onset of end-stage renal disease (ESRD). With the onset of ESRD, 2 of the 10 patients exhibited complete clinical and serological remission, and 2 patients showed clinical remission with persistent serological activity. After an average of 31 months on dialysis, the number of patients in total remission rose to 4 of 11, and the number of clinically inactive but serologically active patients was 1 of 11. Significant clinical and serological activities persisted in 6 of the 11 dialysis patients, requiring low dose steroid therapy in 3. The authors conclude that the clinical and serological activities of SLE decrease with the onset of ESRD and the institution of dialysis, leading to complete or partial remission in the majority of patients.