What are the most common causes of death for clients with systemic lupus erythematosus (SLE)? (Select all that apply.)

Choice A rationale Infection is a major cause of mortality in clients with systemic lupus erythematosus (SLE). SLE often requires treatment with immunosuppressive medications like corticosteroids or chemotherapy agents, which significantly increase the risk of both opportunistic and common bacterial, viral, and fungal infections due to a compromised immune system. Choice B rationale Cardiovascular impairment, including accelerated atherosclerosis, myocardial infarction, and stroke, is a leading cause of death in SLE clients, often stemming from chronic inflammation, vasculitis, and the side effects of prolonged corticosteroid use, such as hypertension and dyslipidemia. Choice C rationale Vasculitis, which is inflammation of the blood vessel walls, is a fundamental pathological process of SLE and contributes to organ damage. While severe vasculitis can be life-threatening, it is typically the underlying cause leading to complications like chronic kidney disease or cardiovascular impairment, rather than the most common singular cause of death itself. Choice D rationale Chronic kidney disease (lupus nephritis) resulting in end-stage renal disease (ESRD) is a common, life-threatening manifestation of SLE. Persistent inflammation and immune complex deposition in the glomeruli lead to progressive loss of kidney function, requiring dialysis or transplantation, and significantly increasing the mortality risk. Choice E rationale Liver failure is not considered one of the most common causes of death in clients with SLE. Although hepatomegaly, elevated liver enzymes, or a condition called lupus hepatitis can occur, they rarely progress to end-stage liver failure as the primary cause of mortality in comparison to renal, cardiovascular, and infectious complications. Choice F rationale Blood dyscrasias, such as severe anemia, leukopenia, and thrombocytopenia, are common features of active SLE. While these can be serious and require treatment, they are generally manageable and less frequently the direct, primary cause of death compared to major organ involvement like cardiovascular disease or infection.