Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Am J Med Sci. 2022 Nov;364(5):529-537. doi: 10.1016/j.amjms.2022.02.014. Epub 2022 May 9.
The spectrum of kidney involvement in systemic sclerosis (SSc) includes scleroderma renal crisis, widely recognized as the most severe renal-vascular complication, but also several forms of chronic renal vasculopathy and reduced renal function are complications of scleroderma. Scleroderma renal crisis, myeloperoxidase-antineutrophil cytoplasmic antibody associated glomerulonephritis, penicillamine-associated renal disease, abnormal urinalysis, alteration of vascular endothelial markers, scleroderma associated-vasculopathy with abnormal renal resistance indices and cardiorenal syndromes type 5 were also reported in SSc patients. A frequent form of renal involvement in SSc patients is a subclinical renal vasculopathy, characterized by vascular damage and normal renal function. Indeed, asymptomatic renal changes, expressed by increase of intrarenal stiffness, are often non-progressive in SSc patients but can lead to a reduction in renal functional reserve. The purpose of this review is to provide an assessment of kidney involvement in SSc, from SRC to subclinical renal vasculopathy.
系统性硬化症（SSc）的肾脏受累谱包括硬皮病肾危象，这被广泛认为是最严重的肾血管并发症，但也有几种慢性肾血管病变和肾功能下降的形式是硬皮病的并发症。硬皮病肾危象、髓过氧化物酶-抗中性粒细胞胞质抗体相关肾小球肾炎、青霉胺相关肾病、尿分析异常、血管内皮标志物改变、硬皮病相关血管病变伴异常肾阻力指数和 5 型心肾综合征也在 SSc 患者中报道。SSc 患者常见的一种肾脏受累形式是亚临床肾血管病变，其特征是血管损伤和正常肾功能。事实上，无症状的肾脏变化，表现为肾内僵硬度增加，在 SSc 患者中往往是不可进展的，但可导致肾功能储备减少。本综述的目的是评估 SSc 患者的肾脏受累情况，从 SRC 到亚临床肾血管病变。
