Renal involvement in autoimmune connective tissue diseases

Area of Science:

• Nephrology
• Rheumatology
• Immunology

Background:

• Connective tissue diseases (CTDs) encompass a range of autoimmune disorders characterized by immune dysregulation and autoantibody production.
• Renal manifestations are common in CTDs, affecting kidney function and complicating disease course.
• Specific CTDs with frequent renal involvement include systemic lupus erythematosus (SLE), systemic scleroderma (SSc), Sjögren syndrome, autoimmune myopathies, antiphospholipid syndrome nephropathy (APSN), and rheumatoid arthritis (RA).

Purpose of the Study:

• To review the impact of CTDs on renal function.
• To discuss the implications of renal impairment for treatment decisions in CTDs.
• To highlight the importance of recognizing and managing kidney complications in patients with autoimmune diseases.

Main Methods:

• Literature review focusing on renal manifestations in various CTDs.
• Analysis of treatment strategies and their impact on renal outcomes.
• Discussion of drug effects on kidney function in the context of CTDs.

Main Results:

• Renal prognosis in SLE has improved with specific classification and biopsy-guided treatments.
• Early angiotensin-converting-enzyme (ACE) inhibitor use and blood pressure control benefit patients with scleroderma renal crisis (SRC).
• Addressing the underlying autoimmune condition or discontinuing offending drugs improves kidney function in Sjögren syndrome, autoimmune myopathies, APSN, and RA.

Conclusions:

• Renal impairment is a significant complication of CTDs, necessitating physician awareness.
• Treatment strategies should be adjusted based on renal involvement and potential drug toxicities.
• Effective management of CTDs and their renal complications can lead to improved patient outcomes.