Clinicopathological study of renal involvement in patients with systemic sclerosis

Abstract

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.