URINARY ALBUMIN EXCRETION IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS WITHOUT RENAL-DISEASE

Objectives-To investigate the prevalence of microalbuminuria, urinary albumin excretion (UAE) between 20-200 mu g/min, in systemic lupus ery thematosus (SLE) patients without clinical renal disease, and to disco ver if this could predict the development of renal disease. Methods-Th is study made six monthly measurements of UAE, creatinine clearance, s erological and clinical data in 22 ambulatory women patients with SLE, without clinical renal disease, hypertension, diabetes or heart failu re. The patients were followed up for a period of18 months (four measu rements). Age and sex matched healthy controls were used as a comparat ive group. UAE was measured by nephelometry in three timed overnight u rine samples at each visit. Results-There were no significant differen ces in the creatinine clearance between the control group and the SLE patients. Creatinine clearance did not show significant changes throug hout the study period. SLE patients had wide variations in the UAE rat e compared with healthy controls. In five patients (5 of 22; 23%), on occasions, there was mild, transient increase in UAE reaching the leve l of microalbuminuria. During follow up, one patient with basal (4.67 mu g/min) and six month (4.73 mu g/min) normal UAE rate, was admitted with a nephrotic syndrome confirmed on biopsy examination to be Method s proliferative lupus nephritis. Six months after beginning treatment with prednisone and cyclophosphamide her UAE rate returned to normal v alues (4.65 mu g/min). Conclusion-SLE patients without clinical renal disease may have microalbuminuria, although this does not seem to warr ant any specific action.