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Kidney involvement in systemic sclerosis: From pathogenesis to treatment
Cosimo Bruni1,2, Giovanna Cuomo3, Francesca W Rossi4
1Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence - Italy.
Systemic sclerosis can affect the kidneys, but scleroderma renal crisis is now better managed with angiotensin-converting enzyme inhibitors. Further research is needed on other kidney involvements in systemic sclerosis.
Area of Science:
- Nephrology
- Rheumatology
- Internal Medicine
Background:
- Kidney involvement in systemic sclerosis is often overlooked, except for scleroderma renal crisis.
- Scleroderma renal crisis mortality has decreased due to treatments like angiotensin-converting enzyme inhibitors.
- Various kidney issues can arise in systemic sclerosis, including proteinuria, reduced filtration, and glomerulonephritis.
Purpose of the Study:
- To review current literature on kidney involvement in systemic sclerosis.
- To highlight the underestimation of non-crisis kidney complications.
- To emphasize the need for further research into prognostic factors.
Main Methods:
- Literature review of systemic sclerosis and kidney involvement.
- Analysis of diagnostic and prognostic tools.
- Summary of current treatment strategies.
Main Results:
- Angiotensin-converting enzyme inhibitors have improved outcomes for scleroderma renal crisis.
- Many other kidney manifestations occur, with limited specific treatments.
- Diagnostic and prognostic tools are evolving.
Conclusions:
- While scleroderma renal crisis is more manageable, other kidney involvements in systemic sclerosis require further investigation.
- No specific treatments are recommended for most kidney complications in systemic sclerosis.
- Understanding the prognostic impact of kidney disease in systemic sclerosis is crucial.
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