[Renal involvement in scleroderma].
Scleroderma renal crisis occurs most often during the first years of the disease, in patients with systemic sclerosis and evolving cutaneous lesions. Clinically, it is responsible for severe hypertension, sometimes associated with cardiac failure or neurological symptoms. Laboratory tests disclose rapidly progressive renal failure, and often signs of thrombotic microangiopathy. If performed (which is rarely the case), renal biopsy shows scleroderma-induced chronic vascular lesions, but also vascular lesions that are secondary to malignant hypertension. The cornerstone of treatment is blood pressure control using angiotensin converting enzyme inhibitors, often in association with other antihypertensive agents. It has to be started as early as possible, in order to optimise vital and renal prognosis.
Boffa
Jean-Jacques
JJ
Service de néphrologie B Hôpital Tenon 75970 Paris.
Rossert
Jérôme
J
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001706:Biopsy; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology*; D011379:Prognosis; D012595:Scleroderma, Systemic / Q000150:complications*; D012720:Severity of Illness Index
D000959:Antihypertensive Agents