Systemic Sclerosis Diagnosis: What Are the Risk Factors for Future Scleroderma Renal Crisis?

Systemic sclerosis (SSc) is a disease of autoimmunity, fibrosis, and vasculopathy—with scleroderma renal crisis (SRC) being one of the most severe complications. In a study published in The Journal of Rheumatology, researchers aim to identify additional clinical characteristics and laboratory findings that could expand and improve the risk profile for future SRC at SSc diagnosis. 

Read more about the risk factors for #scleroderma renal crisis in #SystemicSclerosis. https://t.co/5dRNsws3Bg

— Rheumatology Advisor (@RheumAdvisor) August 7, 2018

Risk Factors for Scleroderma Renal Crisis in Systemic Sclerosis https://t.co/6S1qv42gLq via @RheumAdvisor @jrheum

— The Journal of Rheumatology (@jrheum) August 7, 2018

In this retrospective cohort study, the entire military electronic medical record between 2005 and 2016 was compared for demographics, clinical characteristics, and laboratory results at SSc diagnosis for 31 cases who developed SRC after SSc diagnosis, to 322 SSc without SRC disease controls. 

Risk Factors for #Scleroderma #Renal Crisis in Systemic Sclerosis – https://t.co/FH2E7QT8Hv

— DialysisSaves (@DialysisSaves) August 7, 2018

By the time of SSc diagnosis, conditions that were associated with future SRC included proteinuria (p < 0.001; OR 183, 95% CI 19.1–1750), anemia (p = 0.001; OR 9.9, 95% CI 2.7–36.2), hypertension (p < 0.001; OR 13.1, 95% CI 4.7–36.6), chronic kidney disease (p = 0.008; OR 20.7, 95% CI 2.2–190.7), elevated erythrocyte sedimentation rate (p < 0.001; OR 14.3, 95% CI 4.8–43.0), thrombocytopenia (p = 0.03; OR 7.0, 95% CI 1.2–42.7), hypothyroidism (p = 0.01; OR 2.8, 95% CI 1.2–6.7), Anti-Ro antibody seropositivity (p = 0.003; OR 3.9, 95% CI 1.6–9.8), and ARA (p = 0.02; OR 4.1, 95% CI 1.2–13.8).  

“These patients may benefit from close observation of blood pressure, proteinuria, and estimated glomerular filtration rate, for earlier SRC identification and intervention,” the researchers concluded. “Future prospective therapeutic studies could focus specifically on this high-risk population.” 

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SOURCE: Rheumatology Advisor, The Journal of Rheumatology