To the Editor: The description by Coplon et al. (Jan. 27 issue)1 of the clinical course of patients with systemic lupus erythematosus in end-stage renal disease documents the experience of many nephrologists. The most intriguing aspect is the riddle posed by Ziff and Helderman (Jan. 27 issue)2 — namely, in the absence of azotemia, why is recurrence of systemic lupus erythematosus rare in patients with kidney grafts? One possible explanation is suggested by the report of Ahlin et al.3 that hemodialysis appeared to remove circulating immune complexes (measured with the Raji-cell radioimmunoassay and Clq solid-phase radioimmunoassay) and stabilized renal function. © 1983, Massachusetts Medical Society. All rights reserved.