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The Renal Resistive Index in systemic sclerosis: Determinants, prognostic implication and proposal for specific age-adjusted cut-offs
- Publication Year :
- 2019
- Publisher :
- Elsevier B.V., 2019.
-
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.
- Subjects :
- Male
Percentile
Fibrosi
Blood Pressure
Vasculopathy
Disease
030204 cardiovascular system & hematology
Renal artery Doppler ultrasound
Kidney
Kidney Function Tests
Severity of Illness Index
Systemic sclerosi
Renal Artery
0302 clinical medicine
Fibrosis
030212 general & internal medicine
education.field_of_study
integumentary system
Interstitial lung disease
Middle Aged
Prognosis
Renal Resistive Index
Systemic sclerosis
medicine.anatomical_structure
Italy
Quartile
Cardiology
Female
Adult
medicine.medical_specialty
Prognosi
Population
Age adjustment
03 medical and health sciences
Internal medicine
Internal Medicine
medicine
Humans
education
Aged
Retrospective Studies
Scleroderma, Systemic
Lung
business.industry
Ultrasonography, Doppler
medicine.disease
Survival Analysis
Vascular Resistance
business
human activities
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....ce781461b4af448445165147c58e0072