Clinicopathological study of renal involvement in patients with systemic sclerosis.

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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 nephro-sclerosis.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.