The onset of end-stage renal disease typically leads to quiescence of systemic lupus erythematosus clinical and serologic activity. We report two cases of systemic lupus erythematosus diagnosed for the first time years after dialysis and transplantation, respectively, for idiopathic end-stage renal disease. The transplant patient developed SLE despite ongoing treatment with prednisone and cyclosporine. New onset SLE can occasionally occur despite dialysis or transplantation.