Acute deterioration in renal function in systemic lupus erythematosus.

In a retrospective study of 196 hospital admissions for systemic lupus erythematosus (SLE) over five years acute deterioration in renal function occurred in 36 admissions (18.4 per cent) and was the commonest mode of deterioration of renal function in SLE patients. Active lupus accounted for the majority of cases, with crescentic WHO IV lupus glomerulonephritis (greater than or equal to 50 per cent crescents) the commonest underlying pathology. In 19 per cent of these 36 admissions, it was most likely that concurrent infections at onset precipitated the episodes. Central nervous system lupus and infections were the major causes of death. Recovery of renal function was, however, achieved in 76 per cent using mainly pulse methylprednisolone and immunosuppressives as well as elimination of provoking factors especially infections.