Highlights
- •Renal Resistive Index (RRI) is applicable in systemic sclerosis.
- •RRI reflex renal and extra-renal involvement in scleroderma.
- •RRI has prognostic impact on mortality.
- •Age-SSc adjusted cut offs should be used when measuring RRI in scleroderma patients.
Abstract
Background
Renal Resistive Index (RRI), reflects changes in both renal vascular and tubular-interstitial
compartments and in systemic vascular compliance related to age and comorbidities.
Objectives
a) To investigate determinants of RRI in SSc population, b) its association with SSc-related
features and c) to test its prognostic impact on organ specific worsening or death.
Methods
380 SSc patients ≥18 years were enrolled after giving informed consent. Baseline data
on RRI, laboratory, instrumental and therapeutic features were retrospectively collected.
Age-SSc adjusted cut-offs were created by dividing the population in age quartiles
and considering RRI values >75th percentile as pathologic. Clinical follow-up was
performed until last available visit or the development/worsening of specific internal
organ involvement or death.
Results
RRI was independently predicted by age and systolic pulmonary arterial pressure on
Echo. Therefore, we created Age-SSc adjusted pathologic RRI cut-offs, which were significantly
associated with various disease related skin and lung fibrotic manifestations, as
well as vasculopathic complications. After a mean follow-up of 3.6 ± 2.6 years, RRI
was one of the independent predictors (together with modified Rodnan skin score, interstitial
lung disease, presence of dyspnoea and late nailfold-videocapillaroscopy pattern)
for mortality, with 0.68 as best cut-off (sensitivity 88.5%, specificity 50.9%).
Conclusion
If corroborated, Renal Resistive Index cut-offs might be used to evaluate renal and
extrarenal involvement in SSc and could serve as predictors of mortality.
Keywords
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Article info
Publication history
Published online: September 17, 2019
Accepted:
September 2,
2019
Received in revised form:
August 19,
2019
Received:
April 6,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
