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Renal function is mostly preserved in patients with systemic sclerosis
Scandinavian Journal of Rheumatology , 02/17/09

Scheja A et al. – Only a minority of patients with systemic sclerosis (SSc) develop renal dysfunction other than scleroderma renal crisis (SRC). Decreased glomerular filtration rate (GFR) was associated with other manifestations such as hypertension and cardiac involvement indicating possible pre-renal causes.

Methods

Study examines the occurrence of decreased GFR in a large consecutive SSc cohort
Whether it was related to SSc or could be related to other causes was also analysed
GFR was measured by 51Cr-EDTA or iohexol clearance in 461 SSc pts, and 105 dcSSc pts; measurements repeated once a year
Decreased GFR was defined as GFR<70% of the age-adjusted values
SRC was diagnosed in 4/360 lcSSc (1.1%) and in 10/115 dcSSc (8.7%); these were excluded from further analyses

Results

At a median duration of 7.7 yrs, decreased GFR was found in 11% IcSSC and 8.6% dcSSc pts
Among the 48 SSc pts with GFR<70p%, hypertension was diagnosed in 60%, and cardiac involvement in 52%
Different nephropathies were found in 19% pts by renal biopsy
15 pts with decreased GFR were followed up for ≥4 yrs and no progress was seen in 11/15

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