OUTCOME OF SILENT LUPUS NEPHRITIS

To analyze the long-term outcome in patients with silent lupus nephrit is, we retrospectively studied 20 patients with systemic lupus erythem atosus without clinical renal involvement who had renal biopsies in ou r unit between 1978 and 1996 and reviewed 193 cases reported between 1 957 and 1995. Two patients of the current series were lost to follow-u p. Mean follow-up in the other 18 was 13 +/- 3 years (range, 2 to 17). On kidney biopsy, nine had class I, six class II, one class IV, and t wo class V disease (WHO classification). Three patients with prior nor mal renal function died of nonrenal causes. During the study, the rema ining 15 patients had normal renal function and urinalysis, Most patie nts from the literature had ''mild'' histologic lesions, but 30 had di ffuse proliferative glomerulonephritis. Over an average of 46 months o f follow-up from biopsy, renal survival rate and patient survival rate were 98% and 91%, respectively. Three patients died of end-stage rena l failure. In conclusion, end-stage renal failure in patients with sil ent lupus nephritis is rare regardless of the histopathological renal lesions. Patients survival depends on nonrenal causes. Copyright (C) 1 996 by W.B. Saunders Company