Journalartikel
Autorenliste: Moinzadeh, Pia; Kuhr, Kathrin; Siegert, Elise; Blank, Norbert; Sunderkoetter, Cord; Henes, Joerg; Krusche, Martin; Schmalzing, Marc; Worm, Margitta; Schmeiser, Tim; Guenther, Claudia; Aberer, Elisabeth; Susok, Laura; Riemekasten, Gabriela; Kreuter, Alexander; Zeidler, Gabriele; Juche, Aaron; Hadjiski, Denitsa; Mueller-Ladner, Ulf; Gaebelein-Wissing, Noemi; Distler, Joerg H. W.; Sardy, Miklos; Krieg, Thomas; Hunzelmann, Nicolas
Jahr der Veröffentlichung: 2020
Seiten: 241-248
Zeitschrift: The Journal of Rheumatology
Bandnummer: 47
Heftnummer: 2
ISSN: 0315-162X
eISSN: 1499-2752
DOI Link: https://doi.org/10.3899/jrheum.180582
Verlag: The Journal of Rheumatology
Objective. Scleroderma renal crisis (SRC) is a severe life-threatening manifestation in patients with systemic sclerosis (SSc). However, the knowledge about risk factors for SRC is limited. We determined here the frequency of SRC and identified risk factors for the prediction of SRC. Methods. Based on regular followup data from the German Network for Systemic Scleroderma, we used univariate and multivariate generalized estimating equations to analyze the association between clinical variables, SSc subsets, therapy [i.e., angiotensin-converting enzyme inhibitors (ACEi), corticosteroids], and the occurrence of SRC. Results. Data of 2873 patients with 10,425 visits were available for analysis with a mean number of registry visits of 3.6 +/- 2.8 and a mean time of followup of 3.6 +/- 3.8 years. In total, 70 patients developed SRC (70/ 2873, 2.4%). Of these patients, 57.1% (40/70) were diagnosed with diffuse cutaneous SSc, 31.4% (22/70) with limited cutaneous SSc, and 11.4% (8/70) with SSc- overlap syndromes. Predictive independent factors with the highest probability for SRC were positive anti-RNA polymerase antibodies (RNAP), a history of proteinuria prior to SRC onset, diminished DLCO, and a history of hypertension. Interestingly, positive antitopoisomerase autoantibodies did not predict a higher risk for SRC. Further, patients with SRC were significantly more frequently treated with ACEi and corticosteroids without being independently associated with SRC. Conclusion. In this cohort, SRC has become a rare complication. By far the highest risk for SRC was associated with the detection of anti-RNAP and proteinuria.
Abstract:
Zitierstile
Harvard-Zitierstil: Moinzadeh, P., Kuhr, K., Siegert, E., Blank, N., Sunderkoetter, C., Henes, J., et al. (2020) Scleroderma Renal Crisis: Risk Factors for an Increasingly Rare Organ Complication, The Journal of Rheumatology, 47(2), pp. 241-248. https://doi.org/10.3899/jrheum.180582
APA-Zitierstil: Moinzadeh, P., Kuhr, K., Siegert, E., Blank, N., Sunderkoetter, C., Henes, J., Krusche, M., Schmalzing, M., Worm, M., Schmeiser, T., Guenther, C., Aberer, E., Susok, L., Riemekasten, G., Kreuter, A., Zeidler, G., Juche, A., Hadjiski, D., Mueller-Ladner, U., ...Hunzelmann, N. (2020). Scleroderma Renal Crisis: Risk Factors for an Increasingly Rare Organ Complication. The Journal of Rheumatology. 47(2), 241-248. https://doi.org/10.3899/jrheum.180582
Schlagwörter
DEATH; DISEASE PROGRESSION; GERMAN NETWORK FOR SYSTEMIC SCLERODERMA; INVOLVEMENT; RENAL CRISIS; SCLERODERMA; SCLERODERMA RENAL CRISIS; Systemic sclerosis; SYSTEMIC-SCLEROSIS
