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Incidence of arterial hypertension (AH), its relation with activity of lupus nephritis (LN), other factors (antiphospholipid syndrome, old age, disturbances of purin and lipid metabolism), prognostic implication of AH were studied in a trial performed from 1957 to 1996. A total of 398 patients with LN were divided into 3 groups according to immunosuppressive therapy practiced in different time periods. Overall AH incidence and that of severe AH were similar at present and in the past. AH occurred frequently in patients with rapidly progressing LN and active LN with nephrotic syndrome. In remission of nephrotic syndrome AH incidence was on the decrease. This suggests that hypertension may be a criterion of LN activity. AH was also associated with the presence of antiphospholipid syndrome and old age. AH was a separate prognostic indicator in respect to overall and renal survival. Hemodynamic mechanisms may contribute to LN progression.

ELISA was used to measure tissue plasminogen activator antigen in blood plasma and urine of 42 patients with active lupus nephritis (16 with isolated urinary syndrome, 13 with nephrotic syndrome, 13 with rapidly progressive LN). Control groups consisted of 17 patients with inactive LN and 15 healthy subjects. Inhibition of fibrinolysis in vascular system correlating with the disease severity was found in patients with active LN. This may result from both defective synthesis of tissue plasminogen activator and neutralizing action of antiactivator. Urinary fibrinolytic activity was inhibited only in patients with rapidly progressive LN because of hyperactive synthesis of antiactivator. The above changes occur as endothelial cell dysfunction due to activating and damaging action of immune complexes, antibodies, cytokines on vascular endothelium. Zero activator activity of plasma and urine in patients with active LN reflects severe dysfunction of endothelial cell caused by its structural disorganization.

Venous occlusion test has found out the reserve of vascular and renal endothelium in excretion of Willebrand factor in patients with inactive lupus nephritis and those with active lupus nephritis with urinary syndrome. In severe active lupus nephritis (lupus nephritis with nephrotic syndrome and rapidly progressive lupus nephritis) it was not recorded. This fact evidences intensity of immune inflammation and coagulation in the kidneys in the above forms of lupus nephritis.

The authors studied the content of beta 2-microglobulin (beta 2-MG) in the blood serum and its excretion with the urine in 85 patients with chronic and 35 with lupoid glomerulonephritis (CGN and LGN) depending on the activity of the disease and state of the renal function. In active CGN and LGN one could observe a distinct increase of the content of beta 2-MG in the blood serum and an increase of its excretion with the urine that may be related to presence of marked dystrophic changes of the canalicular apparatus of the kidneys leading to disorders of reabsorption and beta 2-MG catabolism as well as disorders of the immune homeostasis revealed in these diseases. Results indicate that the beta 2-MG levels in the blood serum and urine may be considered as criteria of CGN and LGN activity.