How often will patients with ESKD from lupus nephritis experience extrarenal flares?
Extrarenal flares were initially thought to be extremely infrequent once a patient starts dialysis, a process termed “burnout.” This may be related to the relative immunodeficiency of uremia and/or dialysis, or it may just characterize the progressive course of lupus.
However, in general, patients receiving peritoneal dialysis do not experience fewer extrarenal flares, and modern epidemiologic studies have revealed a persistence of lupus activity, both symptomatically and serologically, in patients undergoing hemodialysis.
This may be related to improved dialysis techniques and biocompatibility of dialysis membranes.
