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Assessment of Cardiorenal Involvement in Systemic Sclerosis Patients.

Chiara Pellicano1, Giancarlo D'Ippolito1, Annalisa Villa1

  • 1Department of Translational and Precision Medicine, La Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.

Biomolecules
|September 27, 2025
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Summary

Systemic sclerosis patients exhibit elevated cardiorenal syndrome (CRS) markers, indicating early heart and kidney damage. Specific biomarkers like galectin-3 and suPAR show promise for detecting CRS in SSc, aiding early diagnosis and management.

Keywords:
cardiorenal syndromechronic kidney diseasepulmonary arterial hypertensionsystemic sclerosis

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Area of Science:

  • Cardiology
  • Nephrology
  • Rheumatology
  • Biomarker Discovery

Background:

  • Systemic sclerosis (SSc) is a severe autoimmune disease with high mortality, often complicated by pulmonary arterial hypertension (PAH), cardiac involvement leading to right heart failure (HF), and chronic kidney disease (CKD).
  • Cardiorenal syndrome (CRS), particularly Type 2 (CKD secondary to chronic HF), highlights the intricate link between cardiovascular and renal systems.
  • Existing diagnostic markers for CRS are often non-specific, necessitating the exploration of more precise biomarkers.

Purpose of the Study:

  • To comprehensively evaluate heart and kidney damage markers associated with CRS in SSc patients.
  • To compare CRS marker levels in SSc patients against healthy controls (HC).
  • To investigate the association between these markers and renal/cardiac ultrasound parameters in SSc.

Main Methods:

  • Assessed specific CRS biomarkers including galectin-3, soluble urokinase plasminogen activator receptor (suPAR), neutrophil gelatinase-associated lipocalin (NGAL), and N-terminal pro-B-type natriuretic peptide (NT-proBNP).
  • Compared marker levels between SSc patients (with and without clinically diagnosed CRS) and HC.
  • Correlated biomarker levels with renal resistive index (RRI) and other ultrasound parameters.

Main Results:

  • SSc patients demonstrated significantly higher CRS marker levels compared to HC (p < 0.001).
  • SSc patients with diagnosed CRS showed elevated levels of galectin-3, suPAR, sNGAL, and uNGAL (p < 0.05) versus those without CRS.
  • Significant positive correlations were observed between RRI and NT-proBNP (r = 0.335, p < 0.05), and RRI and suPAR (r = 0.331, p < 0.05).

Conclusions:

  • NT-proBNP, suPAR, galectin-3, sNGAL, and uNGAL are identified as promising biomarkers for early detection of cardiac and renal involvement in SSc.
  • These biomarkers may aid in identifying SSc patients at risk for developing cardiorenal complications.
  • Further research is warranted to validate these findings and integrate them into clinical practice for improved SSc management.