Lewandowski B, Domysławska I, Klimiuk P A, Sierakowski S
Department of Rheumatology and Internal Diseases, Medical University in Białystok, Poland.
Rocz Akad Med Bialymst. 2005;50 Suppl 1:294-6.
Renal crisis in systemic sclerosis occurs in the group of patients with rapid and aggressive course of the disease, often after several years of the ailment and with the diffuse form. Scleroderma renal crisis (SRC) is most frequently characterized by malignant hypertension, renal insufficiency, and less often by the symptoms of microangiopathic hemolytic anemia. Renal crisis symptoms appear suddenly and are not usually preceded by significant prodromal symptoms. SRC is always life-threatening and requires specific treatment with drugs blocking angiotensin-converting enzyme. Early diagnosis and introducing appropriate treatment give a patient a chance to survive SRC episode and improve his prognosis. SRC is of great importance to clinicians as it still causes high mortality rate. Chronic and subacute renal crisis is connected with a small risk of acute renal failure. However, it gradually leads to a substantial dysfunction of this organ. Thus, a useful examination in the diagnostics of chronic renal crisis is checking the vascular flow in renal cortex and evaluating intrarenal resistance.
系统性硬化症中的肾危象发生在疾病进展迅速且凶险的患者群体中，通常在患病数年且为弥漫型之后出现。硬皮病肾危象（SRC）最常见的特征是恶性高血压、肾功能不全，较少见的是微血管病性溶血性贫血症状。肾危象症状突然出现，通常无明显前驱症状。SRC始终危及生命，需要用血管紧张素转换酶阻断药物进行特殊治疗。早期诊断并采取适当治疗可使患者有机会度过SRC发作期并改善预后。SRC对临床医生非常重要，因为它仍然导致高死亡率。慢性和亚急性肾危象与急性肾衰竭的风险较小有关。然而，它会逐渐导致该器官严重功能障碍。因此，在慢性肾危象诊断中一项有用的检查是检查肾皮质的血流并评估肾内阻力。
