Complications of lupus

Kidney problems

Kidney problems affect about half of people with lupus.⁷ These problems usually don't cause any symptoms, although some people may notice swelling in their legs or ankles (due to fluid retention) that they have not had in the past. The first sign of kidney problems is often abnormal urinalysis findings, such as protein, blood, or white blood cells in the urine or granular or red cell casts (clumps of red blood cells or kidney cells) in the urine.

In a few cases, kidney problems are so severe that the kidneys stop working properly or fail completely. Depending on how severe kidney damage is, treatment can include strong medications to control the lupus, kidney dialysis, or a kidney transplant.

Heart problems

Heart problems caused by lupus include:

• Inflammation of the sac around the heart (pericarditis), the most common lupus-related heart problem.
• Hardening of the arteries that supply blood to the heart muscle. People with lupus are at increased risk of developing plaque deposits in arteries (atherosclerosis) that may cause coronary artery disease. They are also likely to develop plaque deposits at an earlier age than people without lupus.
• Diseases of the heart valves, which affect over 30% of people with long-standing lupus. A few people with lupus may have slightly thickened heart valves, which makes them more susceptible to infections of the damaged valves (endocarditis), blood clots, or heart failure. Some people with damaged heart valves may need surgery to replace the valves.
• Inflammation of the heart muscle (myocarditis), which is uncommon but may lead to problems with the heartbeat or heart muscle. The heart may beat too fast, too slow, or irregularly.

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