The long-term clinical course of systemic lupus erythematosus in end-stage renal disease

N Engl J Med. 1983 Jan 27;308(4):186-90. doi: 10.1056/NEJM198301273080403.


In an attempt to define the long-term clinical course of systemic lupus erythematosus followed by end-stage renal disease, we studied 28 patients with lupus nephritis at Stanford University between January 1969 and December 1980. The clinical and serologic manifestations of both renal and nonrenal disease improved with long-term hemodialysis despite the withdrawal of immunosuppressive drugs in almost all the patients. Rehabilitation was excellent, and a return to normal physical activity was generally the rule. The mortality rate was low (6 of the 28 patients died), but death occurred primarily in patients receiving high doses of prednisone. Recovery from renal failure and discontinuation of dialysis were not rare (eight patients recovered) despite the reduction in immunosuppressive drugs. Renal transplantation was also well tolerated. We found the long-term clinical course of these patients to be comparable to that of patients with end-stage renal disease associated with disorders other than systemic lupus erythematosus.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infections / epidemiology
  • Kidney Failure, Chronic / etiology*
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / mortality
  • Male
  • Middle Aged
  • Nephritis / etiology*
  • Prednisone / therapeutic use
  • Prognosis
  • Renal Dialysis
  • Time Factors


  • Immunosuppressive Agents
  • Prednisone