Renal Changes in Systemic Lupus Erythematosus-Reply

In Reply.—  Thank you for your interest in our recent publication. The questions that you raised about the possible relationship between the use of nonsteroidal anti-inflammatory agents and the acute deterioration of this patient's renal function are relevant but do not appear to apply to this patient.As clearly stated in the text of the article, the patient had not been receiving any medications prior to her hospitalization. She returned to the hospital with the unfilled prescription that was several weeks old. The patient was oliguric for the first 36 hours of hospitalization, during which time no medications except for intravenous fluids were given. During this time her serum creatinine level rose from 1.7 mg/dL at the time of admission to 2.2 mg/dL within the next 24 hours. Therapy with indomethacin, 25 mg three times per day, was begun after the first 36 hours of hospitalization, which was after the