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Scleroderma renal crisis: a review for emergency physicians
Tim Montrief1, Alex Koyfman2, Brit Long3
1Department of Emergency Medicine, Jackson Memorial Hospital/Miller School of Medicine, University of Miami, 1611 N.W. 12th Avenue, Miami, FL, 33136, USA.
Internal and Emergency Medicine
|May 12, 2019
Summary
Scleroderma renal crisis (SRC) is a serious complication of scleroderma, often requiring emergency care. Early recognition and nephrology consultation are key for managing this condition and improving patient outcomes.
Area of Science:
- Nephrology
- Rheumatology
- Emergency Medicine
Background:
- Scleroderma renal crisis (SRC) is a high-risk complication in scleroderma patients.
- Emergency departments (EDs) frequently manage SRC complications and stabilization.
- SRC affects 4-6% of scleroderma patients.
Purpose of the Study:
- To provide an evidence-based summary of emergency medicine evaluation and management of SRC.
- To highlight diagnostic criteria and risk factors for SRC.
- To emphasize the importance of timely nephrology consultation.
Main Methods:
- This is a narrative review of current data.
- Focuses on emergency medicine evaluation and management strategies.
- Summarizes diagnostic criteria and risk factors.
Main Results:
- Diagnostic criteria for SRC include new onset hypertension (BP > 150/85 mmHg or ≥20 mmHg increase) and declining renal function (serum creatinine increase ≥10%).
- Risk factors include diffuse skin thickening, friction rubs, anemia, and cardiac events.
- ED evaluation in a resuscitation bay and nephrology consultation improve outcomes.
Conclusions:
- SRC requires prompt recognition and management in the ED.
- Adherence to diagnostic criteria and awareness of risk factors are crucial.
- Nephrology consultation is vital for optimizing patient care and outcomes.
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