Reversible acute anuric lupus nephritis.

Six cases of acute anuric lupus nephritis are described; renal biopsy showed intracapillary proliferation, epithelial crescents in some glomeruli, wire loops, and intracapillary thrombi. In two patients there were thrombotic occlusions and fibrinoid necrosis of arterioles. The patients were treated by heparin at anticoagulant doses, corticosteroids and dialysis (four). All patients showed improvement of renal function. One died following a gastric haemorrhage - the others were alive and well 64, 61, 40, 40 and 22 months from the onset of renal failure. One patient had a second episode of acute renal failure after 39 months and improved after resumption of heparin and high doses of steroids. It is suggested that heparin and high doses of corticosteroids may be a successful treatment in acute anuric lupus nephritis.