Highlights
- •CKD-EPI is accurate formula to estimate glomerular filtration rate in SSc patients.
- •Renal resistive index is a marker of vascular damage in SSc patients.
- •eGFR is a predictive marker of mortality for SSc and all causes.
- •RRI is a predictive marker of mortality for all causes.
Abstract
Objective
Subclinical nephropathy is underestimated in systemic sclerosis (SSc). Study aim is
to evaluate the role of renal resistance indices (RRI) and estimated glomerular filtration
rate (eGFR) assessed by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)
as predictive markers of mortality during 10 years of follow-up in SSc patients.
Methods
181 SSc patients (60 years, 152 females) were enrolled. At baseline, the GFR was estimated
in 181 SSc patients and RRI was measured in 122 SSc patients. During a follow-up of
10 years we recorded the main complications of disease, date and causes of death.
Results
eGFR shows a linear negative correlation with RRI. RRI showed a correlation with systolic
pulmonary artery pressure (sPAP). Overall survival is lower in SSc patients with eGFR<60
ml/min and RRI ≥0.70 than in SSc patients with eGFR≥60 ml/min (p<0.0001) and with
RRI<0.70 (p<0.01) both for mortality due to SSc and all causes. In multivariate analysis,
eGFR<60 ml/min [HR 6.429, 95%CI (1.006-41.08), p<0.05] and forced vital capacity (FVC) [HR 0.954, 95%CI (0.911-1), p<0.05] are predictive markers of mortality due to SSc, while eGFR [HR 3.617, 95%CI
(1.370-9.554), p<0.01], RRI [HR 0.210, 95% CI (0.068-0.649), p<0.01], age [HR 1.062, 95%CI (1.023-1.103),
p<0.01], FVC [HR 0.967, 95%CI (0.946-0.989), p<0.01] and disease activity index (DAI)
[HR 1.663, 95%CI (1.262-2.191), p<0.0001] are predictive markers of mortality due to all causes.
Conclusion
We demonstrate that eGFR is a predictive marker of mortality due to SSc and to all
causes, conversely RRI is predictive marker of mortality due to all causes.
Keywords
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Article info
Publication history
Published online: February 13, 2021
Accepted:
January 24,
2021
Received in revised form:
January 14,
2021
Received:
December 3,
2020
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
