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Predictors for Scleroderma Renal Crisis

Purpose: To determine if a person with progressive systemic sclerosis (scleroderma) is at risk for developing renal involvement.

Description

Steen et al identified factors that presage development of significant renal involvement in patients with progressive systemic sclerosis (scleroderma). Patients at risk can be monitored more closely and receive early intervention to prevent development of renal failure. The authors are from the University of Pittsburgh.


 

Features of serious scleroderma renal involvement:

(1) abrupt onset of severe arterial hypertension, with a markedly elevated serum renin level

(2) in untreated patients there develops a rapidly progressive oliguric renal failure

 

Patients at risk for scleroderma renal crisis:

(1) patients with diffuse scleroderma who show a rapid progression in skin thickening early in the disease

(2) have one or more of the following

(2a) anemia, with hematocrit < 35% and often with changes of microangiopathic hemolysis

(2b) pericardial effusion

(2c) congestive heart failure

 

Development of a pericardial effusion or onset of congestive heart failure often occurred within a few months of the onset of renal involvement.

 


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Specialty

Objective

ICD-10