The role of the renal biopsy in childhood onset systemic lupus erythematosus: a viewpoint.

Renal disease is a common cause of morbidity and mortality in childhood onset systemic lupus erythematosus (SLE). Renal biopsy findings have some predictive value for renal function; however, this is not significantly greater than can be obtained from routine clinical laboratory investigations. Renal biopsy in childhood SLE should usually be restricted to: a) The child with nephrotic syndrome, so as to distinguish between membranous and diffuse proliferative glomerulonephritis, which have different prognoses and steroid responsiveness, b) The child with deteriorating renal function, to assess the degree of irreversible renal damage, c) The child being entered into a controlled clinical trial.