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The clinical course in 8 patients with systemic lupus erythematosus (SLE) complicated by sever lupus nephritis (LN) with progressive renal insufficiency was investigated to evaluate the therapeutic role of plasma exchange in this disease. In 6 patients treated with corticosteroids and immunosuppressive drugs, only a creatinine level exceeding 4.0 mg% resulted in hemodialysis or death. In 2 patients under additional plasma exchange the creatinine value fell below 4.0 mg% and was stabilized at that level over a now lengthy period of time. It cannot yet be concluded that additional plasma exchange definitely prevents hemodialysis. However, stabilization of renal function could optimize conventional therapy, thereby limiting side effects as well as risk of infection.
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