Until recently, the most common cause of death in people with lupus was kidney failure. Now, with better therapies, access to dialysis, and the possibility of kidney transplantation, the frequency of death from kidney disease has decreased sharply. However, kidney failure is still fatal in some people with lupus.
As death from kidney disease has declined, heart attacks and related cardiovascular diseases have emerged as leading causes of early mortality in people with lupus. The reasons for accelerated heart disease have not been precisely delineated, but it is clear that multiple factors contribute. Therefore, it is especially important for people with lupus to minimize risk factors for heart disease. This means regular exercise, weight control, a low cholesterol diet and cholesterol-lowering medications if necessary, and most importantly no smoking.
Serious infections, often related to the immunosuppressive drugs that may be required to treat severe lupus, also may occasionally be fatal.