The prognosis for a patient with scleroderma renal crisis may vary. A number of factors may identify a patient who is at risk for a poor prognosis and who may benefit from more aggressive management.
Patient selection: scleroderma renal crisis
The mortality rate is about 40% at 5 years.
Factors associated with a poor prognosis:
(1) male gender
(2) older age AND requires dialysis
(3) low or normal blood pressure at presentation
(4) failure to treat aggressively with angiotensin converting enzyme inhibitor (ACEI) or equivalent medication
(5) presence in renal biopsy of fibrinoid necrosis in arterioles and mucoid intimal thickness in arteries
where:
• Teixeira et al use an age cutoff of > 53 years.
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