Clinicopathological study of renal involvement in patients with systemic sclerosis.
OBJECTIVE
To assess the incidence of renal involvement in patients with systemic sclerosis (SSc) as well as its clinical and pathological changes.


METHODS
The renal involvement was studied clinicopathologically in 93 patients who were compatible with the diagnosis of SSc retrospectively.


RESULTS
Eighteen patients (19.4%) were diagnosed as renal involvement by one or more of the following: proteinuria, renal hypertension, elevated levels of blood urea nitrogen (BUN) and/or serum creatinine (sCr). Renal impairment was observed in 5 patients (5.4%). The mortality rate was 12.9%, and 5 patients died of renal failure. Histological study was performed in 5 patients. The thickening of interlobular arterioles with intimal proliferation was found in 4 of the patients who also showed mild nonspecific glomerular changes. Two had no clinical features of renal involvement, 1 had renal hypertension and 1 died of renal failure. Another patient with a 22-year disease duration showed chronic glomerulonephritis with nephrosclerosis.


CONCLUSIONS
SSc patients should be followed-up clinically and renal biopsy performed if necessary in order to discover early renal involvement and to insert rational therapy to improve its prognosis.
Zeng
X
X
Department of Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, PUMC Hospital, Beijing, China.
Chen
J
J
Dong
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000473:pathology