Thirty women with systemic lupus erythematosus were categorized into groups with and without significant renal involvement on the basis of renal biopsy and subsequently followed for an average of 9.4 years. At this time 53% of the patients with renal disease and 70% of the “nonrenal” patients had died. While 80% of the deaths in the “renal” group were due to renal disease, none of the nonrenal patients died of this complication. Major central nervous system involvement was eventually noted in 100% of the nonrenal group. After 8.3 years, mortality in the nonrenal patients exceeded that in the renal group, mainly because of the emergence of central nervous system disease.