Background Renal disease is a common manifestation of systemic lupus erythematosus (SLE). However, there continues to be debate about the best therapeutic option(s).

Objectives This objective of this study was to look at the response rate and complications of previous treatment(s) given for their lupus nephritis.

Methods A retrospective cross-sectional survey of the case notes of SLE patients under current follow-up at University Hospital, Kuala Lumpur, from June to August 2000 was undertaken.

Results A total of 103 patients (97F, 6M) were studied of whom 48 (46.6%) had renal involvement at presentation. The WHO classification of the first renal biopsy was: class I – 6(5.8%), class II – 10(9.7%), class III – 4(3.9%), class IV – 58(56.3%), class V – 18(17.5%). We present the results for class IV disease (Table 1). Six patients had prednisolone only of whom 2 went into remission, 3 patients had IV Cyclophosphamide (CPM) followed by oral CPM and all went into remission. Drug-related complications were noted in 63 (61.2%) patients. Prednisolone, oral CPM, IV CPM and Azathioprine (Aza) were responsible for 36.5%, 28.6%, 17.5% and 12.7% of complications respectively.

Conclusion In this cohort of class IV lupus nephritis patients, IV CPM, closely followed by oral CPM, are the agents of choice in inducing remission, but this is associated with a higher complication rate than Aza alone.