Evaluation of treatment in lupus nephritis: effects of prednisone.

Survival of patients with SLE and renal disease has improved in the past 25 yr. There are numerous variables in patients with SLE, and many factors are important in determining outcome. The precise role of any therapeutic regimen in improving survival is unproven. Patients with SLE with normal kidneys, with mesangial changes or with membranous glomerulonephropathy do well whatever treatment is used. Focal and diffuse proliferative glomerulonephritis has a poor prognosis without treatment. Prednisone treatment appears to have improved the survival, but it is probable that treatment with prednisone alone may be less effective than a regimen in which it is combined with cyclophosphamide or nitrogen mustard.