Lupus - Complications of lupus

If your symptoms of systemic lupus erythematosus (SLE) are mild or well-controlled, you may find it barely affects your day-to-day life and that you do not have any complications.

However, for some people, SLE can be a more serious condition that can cause life-threatening complications. Some of these complications are outlined below.

Kidney problems

Around one in every three people with SLE will develop a potentially serious kidney disease called lupus nephritis, which is caused by prolonged inflammation of the kidneys.

Lupus nephritis tends to develop relatively early in the course of SLE, usually within five years of diagnosis.

Symptoms of lupus nephritis can include:

swelling of your feet (oedema)
headaches
dizziness
blood in your urine
a frequent need to urinate

Lupus nephritis can also cause high blood pressure (hypertension). If left untreated, it can put you at risk of developing life-threatening problems such as a heart attack or stroke.

In many cases, lupus nephritis does not cause any noticeable symptoms. However, this does not mean the condition is not dangerous, as the kidneys could still be being damaged.

If you have SLE, it is likely you will need to have regular blood tests so the condition of your kidneys can be carefully monitored. If you develop lupus nephritis, it can usually be successfully controlled using immunosuppressants such as mycophenolate mofetil or cyclophosphamide.

In a small number of cases, the kidney damage can become severe enough to require treatment with dialysis (where a machine is used to replicates many of the kidneys' functions) or a kidney transplant.

Cardiovascular disease

Cardiovascular disease (CVD) is a general term for any type of health condition that affects the heart and arteries. It is often associated with blood clots and atherosclerosis (hardening and narrowing of the arteries).

Examples of CVD include coronary heart disease, angina (chest pain caused by the heart not receiving enough blood), heart attack and stroke.

People with SLE are more likely to develop CVD than the general population, because SLE can cause your heart and arteries to become inflamed and damaged.

If you have SLE, you can reduce your risk of CVD by making health lifestyle chances, such as:

stopping smoking if you smoke
eating a healthy, balanced diet low in saturated fat, sugar and salt, and containing at least five portions of fruit and vegetables a day
maintaining a healthy weight
exercising regularly – at least 150 minutes (two-and-a-half hours) a week of exercise strenuous enough to leave you slightly out of breath is recommended
cutting down on your alcohol consumption

Pregnancy complications

SLE does not usually affect fertility, but it can increase your risk of experiencing pregnancy complications, such as:

pre-eclampsia (a condition that causes high blood pressure during pregnancy)
premature delivery
miscarriage
stillbirth

Some children of women with SLE can also be born with heart block (where electrical pulses that control the beating of the heart are disrupted) and rashes. This is known as "neonatal lupus syndrome".

If you have SLE and are thinking of having a baby, it is best to plan this carefully with your doctors if possible. The risk of complications is higher if you become pregnant during periods where your symptoms are particularly severe, so you will usually be advised to try to avoid getting pregnant until your symptoms are better controlled.

If you do become pregnant, you will need to be monitored closely by your specialist and by an obstetrician, so they can check for any problems.