The Scleroderma Kidney: Progress in Risk Factors, Therapy, and Prevention
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Guillaume Bussone & Alice Bérezné & Vincent Pestre & Loïc Guillevin & Luc Mouthon
- چاپ و سال / کشور: 2010
Description
Scleroderma renal crisis (SRC) is characterized by malignant hypertension, oliguric/anuric acute renal failure, and important mortality, with a 5-year survival rate of 65%. SRC occurs in 2% to 5% of patients with systemic sclerosis (SSc), particularly those with diffuse cutaneous SSc in the first years of disease evolution. Several retrospective studies have found high-dose corticosteroid therapy to be associated with increased risk of SRC, and anti-RNA-polymerase III antibodies have been detected in one third of patients with SRC. Treatment relies on the early control of blood pressure with increasing doses of angiotensin-converting enzyme inhibitors, eventually associated with calcium channel blockers together with dialysis if necessary. After 2 years on dialysis, eligible patients should be considered for renal transplantation. The strategy for prevention of SRC lacks consensus. However, corticosteroids and/or nephrotoxic drugs should be avoided in patients with diffuse cutaneous SSc.
Curr Rheumatol Rep (2011) 13:37–43 DOI 10.1007/s11926-010-0145-7 Published online: 9 November 2010
