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Clinicopathological study of renal involvement in patients with systemic sclerosis
1Department of Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, PUMC Hospital, Beijing, China.
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.