Stock G G, Krane N K
Tulane University School of Medicine, Department of Medicine, New Orleans, Louisiana.
Adv Perit Dial. 1993;9:147-51.
End-stage renal disease (ESRD) is one of the most significant complications of systemic lupus erythematosus (SLE). Previous investigators have evaluated the morbidity and mortality of different renal replacement treatment modalities in these patients. Earlier reports have suggested that the systemic manifestations of SLE diminish, or "burn out," once ESRD occurs. These investigators also suggested that vascular access complications were a significant cause of morbidity and mortality in these patients treated with hemodialysis (HD). A retrospective review of the records of 6 patients with ESRD from lupus nephritis (LN), who received both HD and peritoneal dialysis (PD), was performed to determine if there was a difference in disease activity between treatment modalities, using patients as self-controls. The number of SLE flares was determined by clinical and/or serologic studies, and prednisone dosages compared for each treatment modality. Four of the 6 patients continued to have active SLE after renal replacement therapy was begun. There were no significant differences in the number of SLE flares or prednisone dosages while receiving either treatment modality. While PD eliminates problems associated with vascular access, both HD and PD were effective forms of renal replacement therapy. Most patients in this study continued to have active SLE after commencement of dialysis, with no differences in disease activity noted during HD or PD.
终末期肾病（ESRD）是系统性红斑狼疮（SLE）最严重的并发症之一。既往研究人员评估了这些患者不同肾脏替代治疗方式的发病率和死亡率。早期报告表明，一旦发生ESRD，SLE的全身表现会减轻或“消退”。这些研究人员还指出，血管通路并发症是接受血液透析（HD）治疗的这些患者发病和死亡的重要原因。对6例狼疮性肾炎（LN）所致ESRD且接受过HD和腹膜透析（PD）的患者记录进行回顾性分析，以患者自身作为对照，确定不同治疗方式之间疾病活动度是否存在差异。通过临床和/或血清学研究确定SLE发作次数，并比较每种治疗方式下的泼尼松剂量。6例患者中有4例在开始肾脏替代治疗后SLE仍处于活动期。接受任何一种治疗方式时，SLE发作次数或泼尼松剂量均无显著差异。虽然PD消除了与血管通路相关的问题，但HD和PD都是有效的肾脏替代治疗方式。本研究中的大多数患者在开始透析后SLE仍处于活动期，HD或PD期间疾病活动度无差异。
