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Renal dysfunction in systemic sclerosis beyond scleroderma renal crisis

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Abstract

Research regarding renal involvement in SSc has almost exclusively focused on scleroderma renal crisis (SRC). There are relatively limited data regarding renal impairment in SSc beyond SRC. We performed an electronic search using the key words systemic sclerosis or scleroderma combined with each of the following: renal dysfunction, kidney, glomerular filtration rate (GFR), proteinuria and hematuria. We searched for reports relevant to renal dysfunction in SSc beyond SRC. In 796 SSc patients recruited in five studies. 251 (31.5%) had GFR < 90 ml/min whereas 155(19.5%) patients had GFR < 60 ml/min. Most data indicate that the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula should be considered as the most suitable tool for assessing renal function in SSc pts, since it provides similar results to measured GFR. These data indicate that renal dysfunction in SSc in not uncommon and therefore patients with SSc should have their renal function assessed by GFR estimation on a regular basis.

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References

  1. Cutolo M, Soldano S, Smith V (2019) Pathophysiology of systemic sclerosis: current understanding and new insights. Expert review of clinical immunology, vol 15. Taylor and Francis Ltd, Milton Park, pp 753–764

    Google Scholar 

  2. Smith V, Scirè CA, Talarico R, Airo P, Alexander T, Allanore Y et al (2018) Systemic sclerosis: State of the art on clinical practice guidelines. RMD Open, vol 4. BMJ Publishing Group, London, p 20

    Google Scholar 

  3. Asano Y (2020) The pathogenesis of systemic sclerosis: an understanding based on a common pathologic cascade across multiple organs and additional organ-specific pathologies. J Clin Med 9(9):2687

    Article  Google Scholar 

  4. Barsotti S, Orlandi M, Codullo V, Di Battista M, Lepri G, Della RA et al (2019) One year in review 2019: systemic sclerosis. Clin Exp Rheumatol 119:S3-14

    Google Scholar 

  5. Denton CP, Khanna D (2017) Systemic sclerosis, vol 390. Lancet Publishing Group, London, pp 1685–1699

    Google Scholar 

  6. Steen VD, Medsger TA (2007) Changes in causes of death in systemic sclerosis, 1972–2002. Ann Rheum Dis 66(7):940–944

    Article  Google Scholar 

  7. Bose N, Chiesa-Vottero A, Chatterjee S (2015) Scleroderma renal crisis. Seminars in arthritis and rheumatism, vol 44. W.B. Saunders, Philadelphia, pp 687–694

    Google Scholar 

  8. Perelas A, Silver RM, Arrossi AV, Highland KB (2020) Systemic sclerosis-associated interstitial lung disease. The Lancet respiratory medicine, vol 8. Lancet Publishing Group, London, pp 304–320

    Google Scholar 

  9. Anders HJ, Saxena R, Zhao-hui M, Parodis I, Salmon JE, Mohan C (2020) Lupus nephritis. Vol. 6. Nature Reviews Disease Primers. Nature Research

  10. Binda V, Moroni G, Messa P (2018) ANCA-associated vasculitis with renal involvement. J Nephrol (Springer) 31:197–208

    Article  CAS  Google Scholar 

  11. Daoussis D, Panoulas VF, Antonopoulos I, John H, Toms TE, Wong P et al (2010) Cardiovascular risk factors and not disease activity, severity or therapy associate with renal dysfunction in patients with rheumatoid arthritis. Ann Rheum Dis 69(3):517

    Article  CAS  Google Scholar 

  12. Couderc M, Tatar Z, Pereira B, Tiple A, Gilson M, Fautrel B et al (2016) Prevalence of renal impairment in patients with rheumatoid arthritis: results from a cross-sectional multicenter study. Arthritis Care Res (Hoboken) 68(5):638–644

    Article  Google Scholar 

  13. Vallianou NG, Mitesh S, Gkogkou A, Geladari E (2018) Chronic kidney disease and cardiovascular disease: is there any relationship? Curr Cardiol Rev 15(1):55–63

    Article  Google Scholar 

  14. Amann K, Wanner C, Ritz E (2006) Cross-talk between the kidney and the cardiovascular system. J Am Soc Nephrol 17(8):2112–2119

    Article  CAS  Google Scholar 

  15. Pagkopoulou E, Arvanitaki A, Daoussis D, Garyfallos A, Kitas G, Dimitroulas T (2019) Comorbidity burden in systemic sclerosis: beyond disease-specific complications. Rheumatol Int 39(9):1507–1517

    Article  Google Scholar 

  16. Vart P, Grams ME (2016) Measuring and assessing kidney function. Seminars in nephrology (W.B. Saunders) 36: 262–72.

  17. Caron M, Hudson M, Baron M, Nessim S, Steele R, Pope J et al (2012) Longitudinal study of renal function in systemic. J Rheumatol 39(9):1829–1834

    Article  Google Scholar 

  18. Scheja A, Bartosik I, Wuttge DM, Hesselstrand R (2009) Renal function is mostly preserved in patients with systemic sclerosis. Scand J Rheumatol 38(4):295–298

    Article  CAS  Google Scholar 

  19. Gupta R, Bammigatti C, Dinda AK, Marwaha V, Gupta S (2007) Prevalence of renal involvement in Indian patients with systemic sclerosis. Indian J Med Sci 61(2):91–96

    Article  CAS  Google Scholar 

  20. Rosato E, Gigante A, Barbano B, Gasperini ML, Cianci R, Muscaritoli M (2018) Prognostic factors of renal involvement in systemic sclerosis. Kidney Blood Press Res 43(3):682–689

    Article  CAS  Google Scholar 

  21. Suebmee P, Foocharoen C, Mahakkanukrauh A, Suwannaroj S, Theerakulpisut D, Nanagara R (2016) Correlation of glomerular filtration rate between renal scan and estimation equation for patients with scleroderma. Am J Med Sci 352(2):166–171

    Article  Google Scholar 

  22. Gigante A, Rosato E, Massa R, Rossi C, Barbano B, Cianci R et al (2012) Evaluation of chronic kidney disease epidemiology collaboration equation to estimate glomerular filtration rate in scleroderma patients. Rheumatology 51(8):1426–1431

    Article  CAS  Google Scholar 

  23. Mohamed RHA, Zayed HS, Amin A (2010) Renal disease in systemic sclerosis with normal serum creatinine. Clin Rheumatol 29(7):729–737

    Article  Google Scholar 

  24. Jufar AH, Lankadeva YR, May CN, Cochrane AD, Bellomo R, Evans RG (2020) Renal functional reserve: From physiological phenomenon to clinical biomarker and beyond. Am J Physiol Regul Integr Comp Physiol 319:R690-702

    Article  CAS  Google Scholar 

  25. Amin A, El-Sayed S, Taher N, Sedki M, Nasr H (2012) Tc-99m diethylenetriamine pentaacetic acid (DTPA) renal function reserve estimation: is it a reliable predictive tool for assessment of preclinical renal involvement in scleroderma patients. Clin Rheumatol 31(6):961–966

    Article  Google Scholar 

  26. Livi R, Guiducci S, Perfetto F, Ciuti G, Grifoni E, Conforti L et al (2011) Lack of activation of renal functional reserve predicts the risk of significant renal involvement in systemic sclerosis. Ann Rheum Dis 70(11):1963–1967

    Article  CAS  Google Scholar 

  27. Livi R, Teghini L, Pignone A, Generini S, Matucci-Cerinic M, Cagnoni M (2002) Renal functional reserve is impaired in patients with systemic sclerosis without clinical signs of kidney involvement. Ann Rheum Dis 61(8):682–686

    Article  CAS  Google Scholar 

  28. Seiberlich B, Hunzelmann N, Krieg T, Weber M, Schulze-Lohoff E (2008) Intermediate molecular weight proteinuria and albuminuria identify scleroderma patients with increased morbidity. Clin Nephrol 70(2):110–117

    Article  CAS  Google Scholar 

  29. Schuster J, Moinzadeh P, Kurschat C, Benzing T, Krieg T, Weber M et al (2013) Proteinuria in systemic sclerosis: reversal by ACE inhibition. Rheumatol Int 33(9):2225–2230

    Article  CAS  Google Scholar 

  30. Daoussis D, Liossis S-N (2019) Treatment of systemic sclerosis associated fibrotic manifestations: current options and future directions. Mediterr J Rheumatol 30(1):33–37

    Article  Google Scholar 

  31. Melissaropoulos K, Kraniotis P, Bogdanos D, Dimitroulas T, Sakkas L, Daoussis D (2019) Targeting very early systemic sclerosis: a case-based review. Rheumatol Int (Springer) 39:1961–1970

    Article  Google Scholar 

  32. Trocchi P, Girndt M, Scheidt-Nave C, Markau S, Stang A (2017) Impact of the estimation equation for GFR on population-based prevalence estimates of kidney dysfunction. BMC Nephrol 18(1):341

    Article  Google Scholar 

  33. Hickson LJ, Crowson CS, Gabriel SE, McCarthy JT, Matteson EL (2014) Development of reduced kidney function in rheumatoid arthritis. Am J Kidney Dis 63(2):206–213

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Rheumatology, University of Patras Medical School, Patras, Greece

    George Iliopoulos & Dimitrios Daoussis

  2. Department of Internal Medicine, Division of Rheumatology, Patras University Hospital, Rion, 265 04, Patras, Greece

    Dimitrios Daoussis

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  1. George Iliopoulos
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  2. Dimitrios Daoussis
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Contributions

GI performed the literature search, statistical analysis and assisted in manuscript drafting. DD conceived the idea of the review, assisted in literature search and drafted the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Dimitrios Daoussis.

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Iliopoulos, G., Daoussis, D. Renal dysfunction in systemic sclerosis beyond scleroderma renal crisis. Rheumatol Int 41, 1203–1208 (2021). https://doi.org/10.1007/s00296-021-04855-x

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