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

Despite treatment advances, renal failure still develops in patients with systemic lupus erythematosus (SLE). With the common use of long-term maintenance hemodialysis, this complication is no longer fatal. In order to evaluate factors that contribute to the outcome of patients with SLE receiving long-term hemodialysis, we retrospectively analyzed the clinical course of 14 patients with SLE receiving hemodialysis for more than three months, and compared them with 62 patients receiving long-term hemodialysis who did not have SLE. While receiving long-term hemodialysis, SLE activity was minimal, with most manifestations involving the CNS or synovitis. Five-year survival was significantly lower in the SLE than in the non-SLE group (58.6% v 88.5%), but no deaths were directly attributable to SLE activity. Morbidity in the SLE group was primarily due to infection and vascular access problems.