RENAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS; A CLINICAL AND PATHOLOGIC STUDY OF 90 CASES

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Abstract
Renal manifestations were studied in 90 patients with systemic lupus erythematosus. The investigation served to emphasize the grave prognostic implications of involvement of the kidneys in this illness. Impaired renal function was usually found in those who succumbed, the majority of the patients with renal disease living less than 3 years. Amounts of corticotropin or glucogenic steroids sufficient to suppress the other manifestations of the disease had no effect either on the prevention or the amelioration of renal damage. The patients with kidney involvement generally manifested it early in the course of the illness. The longer the disease continued without the development of this complication, the less likely was it to occur. The mean duration of survival following the onset of nephrosis was 8 months although the normocholesterolemic variant offered a somewhat better outlook. The 15-minute excretion of phenolsul-phonphthalein and the creatinine clearance test yielded the most useful information in terms of appraisal of renal status. A study of throat cultures and antistreptolysin O titers failed to demonstrate more than a coincidental relationship between the beta-hemolytic streptococcus infection and the renal involvement. Antibiotic therapy however, appeared to have prolonged the life of a number of the patients studied, perhaps secondary to the prevention of intercurrent infections.