Acute Deterioration in Renal Function in Systemic Lupus Erythematosus

In a retrospective study of 196 hospital admissions for systemiclupus erythematosus (SLE) over five years acute deteriorationin renal function occurred in 36 admissions (18.4 per cent)and was the commonest mode of deterioration of renal functionin SLE patients. Active lupus accounted for the majority ofcases, with crescentic WHO IV lupus glomerulonephritis (>50 per cent crescents) the commonest underlying pathology. In19 per cent of these 36 admissions, it was most likely thatconcurrent infections at onset precipitated the episodes. Centralnervous system lupus and infections were the major causes ofdeath. Recovery of renal function was, however, achieved in76 per cent using mainly pulse methylprednisolone and immunosuppressivesas well as elimination of provoking factors especially infections.