Persistence of clinical and serologic activity in patients with systemic lupus erythematosus undergoing peritoneal dialysis

https://doi.org/10.1016/0002-9343(87)90888-6Get rights and content

Abstract

To determine whether patients with systemic lupus erythematosus undergoing long-term peritoneal dialysis have persistent clinical and serologic remissions, the clinical courses of eight patients with endstage renal disease in whom peritoneal dialysis was begun at Rush-Presbyterian-St. Luke's Medical Center between 1981 and 1986 were analyzed. Patients were followed for a mean of 90.1 ± 28.8 months before dialysis and 20.8 ± 4.7 months after the initiation of dialysis. Disease activity was quantified for each individual in terms of “flares” per year before and after the initiation of peritoneal dialysis, the means of which were 0.66 ± 0.46 and 0.94 ± 0.28, respectively. Comparison of these rates showed no statistical difference. Seven of the eight patients had at least one flare while receiving peritoneal dialysis, all of which required prednisone therapy (mean 31.3 mg per day). The clinical manifestations included fever, rash, myalgias, anemia, leukopenia, serositis, and cerebritis. Eighty-eight percent of these flares had associated worsening of serologic results. Prednisone was discontinued in only one patient at any time during peritoneal dialysis. This experience reveals that patients with lupus continue to show clinical and serologic disease activity and require maintenance prednisone therapy while receiving long-term peritoneal dialysis.

References (29)

  • MP Jarrett et al.

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

    Arch Intern Med

    (1983)
  • AS Cohen et al.

    Preliminary criteria for the classification of systemic lupus erythematosus

    Bull Rheum Dis

    (1971)
  • NS Coplon et al.

    Letter to the editor

    N Engl J Med

    (1983)
  • GG Wu et al.

    Reactivation of systemic lupus in three patients undergoing CAPD

    Periton Dial Bull

    (1986)
  • Cited by (40)

    • Assessment of lupus activity for Egyptian patients on regular hemodialysis, is there a need for prolonged immunosuppressive therapy?

      2019, Egyptian Rheumatologist
      Citation Excerpt :

      Correia et al. also reported that 33% of cases had evidences of active SLE [27]. Rodby et al reported 8 clinical flares in 7 patients [28] while Goo et al retrospectively studied 45 patients with SLE and ESRD and observed that after the first year of dialysis, serological markers of the disease were present in 80%; in the second and third years, they remained active in 60% and 52%, respectively [24]. In another case control study, 50% developed lupus flares after HD [29].

    • Complementary and alternative medications, specialized and niche therapies

      2018, Dubois' Lupus Erythematosus and Related Syndromes
    • Specialized Treatment Approaches and Niche Therapies for Lupus Subsets

      2012, Dubois' Lupus Erythematosus and Related Syndromes: Eighth Edition
    • Lupus nephritis

      2012, Nephrology Secrets
    • Lupus nephritis

      2011, Nephrology Secrets
    View all citing articles on Scopus

    From the Section of Nephrology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.

    View full text