Proteinuria, anemia, elevated erythrocyte sedimentation rate, hypertension, chronic kidney disease, thrombocytopenia, hypothyroidism, and Anti-Ro antibody seropositivity are risk factors for developing scleroderma renal crisis in patients with systemic sclerosis (SSc), according to a study recently published in The Journal of Rheumatology.
This retrospective study examined records from 353 patients diagnosed with SSc for common demographic features, clinical characteristics, and laboratory result at the time of diagnosis. There were 31 patients who went on to develop scleroderma renal crisis (median of 3 years). Patients who developed scleroderma renal crisis were more likely to have proteinuria (P <.001), anemia (P =.001), elevated erythrocyte sedimentation rate (P <.001),hypertension (P <.001), chronic kidney disease (P =.008), thrombocytopenia (P =.03), Anti-Ro antibody seropositivity (P=.003), and hypothyroidism (P =.01) at the time of diagnosis compared with patients who did not have these characteristics. The likelihood of developing scleroderma renal crisis increased with the number of risk factors present at diagnosis.
Of the patients who developed scleroderma renal crisis, 94% had 2 or more risk factors present at diagnosis (P <.001), and of the patients who did not develop scleroderma renal crisis, 0% had 4 or more risk factors (P <.001).
A limitation of this retrospective study is the potential for incomplete data marks on all patients, such as if the patient sought out treatment at more than 1 location, if specific organ involvement was missed at initial diagnosis, or a potential lack of laboratory technology to diagnose precise abnormalities.
In conclusion, this study highlights the potential risk factors of developing scleroderma renal crisis at time of diagnosis in systemic sclerosis, which can provide this high-risk population some guidelines for follow-up markers.
Gordon SM, Stitt RS, Nee R, et al. Risk factors for future scleroderma renal crisis at systemic sclerosis diagnosis. [published online July 15, 2018]. J Rheumatol. doi:10.3899/jrheum.171186