Criteria for Scleroderma Renal Crisis

 

Parameters:

(1) rise in blood pressure (new onset hypertension)

(2) rise in serum creatinine

(3) proteinuria

(4) hematuria

(5) thrombocytopenia

(6) hemolysis

(7) changes on renal biopsy

 

Criteria for new onset hypertension - one or more of the following:

(1) systolic blood pressure >= 140 mm Hg

(2) diastolic blood pressure >= 90 mm Hg

(3) rise in systolic blood pressure >= 30 mm Hg

(4) rise in diastolic blood pressure >= 20 mm Hg

 

Criteria for a rise in serum creatinine - one of the following:

(1) increase > 50% over baseline

(2) serum creatinine >= 1.2 * (upper limit of reference range)

Additional Findings	Criteria
proteinuria	>= 2+ on dipstick
hematuria	>= 2+ on dipstick OR >= 10 RBC per high power field (hpf) in urine sediment
thrombocytopenia	< 100,000 per µL
hemolysis	anemia not due to other cause with either (a) schistocytes or red cell fragments in blood smear OR (b) increased reticulocyte count
renal biopsy	microangiopathy consistent with scleroderma renal crisis

 

Criteria for hypertensive scleroderma renal crisis - both of the following:

(1) presence of new onset hypertension

(2) one or more of the following:

(2a) rise in serum creatinine

(2b) proteinuria

(2c) hematuria

(2d) thrombocytopenia

(2e) hemolysis

 

Criteria for normotensive scleroderma renal crisis - all 3 of the following:

(1) absence of new onset hypertension

(2) rise in serum creatinine

(3) one or more of the following:

(3a) proteinuria

(3b) hematuria

(3c) thrombocytopenia

(3d) hemolysis

(3e) renal biopsy findings