End-Stage Renal Disease in Systemic Lupus Erythematosus

To the Editor: The description by Coplon et al. (Jan. 27 issue) 1 of the clinical course of patients with systemic lupus erythematosus in end-stage renal disease documents the experience of many nephrologists. The most intriguing aspect is the riddle posed by Ziff and Helderman (Jan. 27 issue) 2 — namely, in the absence of azotemia, why is recurrence of systemic lupus erythematosus rare in patients with kidney grafts? One possible explanation is suggested by the report of Ahlin et al. 3 that hemodialysis appeared to remove circulating immune complexes (measured with the Raji-cell radioimmunoassay and Clq solid-phase radioimmunoassay) and stabilized renal function . . . No extract is available for articles shorter than 400 words.