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  • 5 -8 (58) 2023 — Abdullaeva U.K.,  Nabieva D.A. — MODERN CONCEPTS OF KIDNEY DAMAGE IN PATIENTS WITH SYSTEMIC SCLERODERMA

5 -8 (58) 2023 — Abdullaeva U.K.,  Nabieva D.A. — MODERN CONCEPTS OF KIDNEY DAMAGE IN PATIENTS WITH SYSTEMIC SCLERODERMA

MODERN CONCEPTS OF KIDNEY DAMAGE IN PATIENTS WITH SYSTEMIC SCLERODERMA

Abdullaeva U.K., Bukhara State Medical Institute named after Abu Ali ibn Sina

Nabieva D.A., Tashkent Medical Academy

Yusupov I.K. Rheumatologist of the private clinic “Premium medical”

Resume

Systemic sclerosis, or systemic scleroderma (SSD), is an autoimmune disease of connective tissue, the main clinical signs of which are caused by widespread microcirculation disorders, fibrosis of the skin and internal organs. According to morphological studies, 80% of patients with SSD have kidney changes, including those not associated with rheumatic diseases. While the prevalence of sclerodermic renal crisis is currently estimated at 2-5%, an asymptomatic decrease in renal function (“mute uremia”) due to the presence of multimorbid and comorbid pathology is much more often noted. Its frequency in patients with SSD can reach 55%. The fact of the presence of autoimmune connective tissue disease itself can be considered as a risk factor for kidney damage. The fifteen–year survival rate of patients with CVD without kidney damage is 72%, in the presence of kidney damage – no more than 13%. The presence of proteinuria in patients with SSD is one of the most significant independent risk factors for death (the relative risk is 3.34), leaving far behind such canonical risk factors as pulmonary arterial hypertension, pulmonary restriction (the ratio of forced expiratory volume in 1 s and forced vital capacity of the lungs <80%), respiratory failure (III and class IV according to NYHA), as well as a decrease in the diffusion capacity of the lungs and a high skin score.

Keywords: systemic scleroderma; sclerodermic renal crisis; vascular endothelial dysfunction; chronic sclerodermic nephropathy; nonimmune factors of nephropathy progression; chronic kidney disease..

First page

29

Last page

36

For citation: Abdullaeva U.K.,  Nabieva D.A., Yusupov I.K. – MODERN CONCEPTS OF KIDNEY DAMAGE IN PATIENTS WITH SYSTEMIC SCLERODERMA //New Day in Medicine 2023 8(58): 29-36 https://newdaymedicine.com/index.php/2023/08/05/l-293/

LIST OF REFERENCES:

  1. Guseva N.G. Sistemnaya sklerodermiya [Systemic scleroderma]. /Moscow: Meditsina; 1975; 270. (In Russ.)
  2. Auspitz H. Ein beitrag zur lehre vom haut-sklerem der erwachsenen. //Wien Med Wochenschr. 1863;XIII:755.
  3. Lynch B, Burns A. Rheumatological Conditions and the Kidney. //In: Harber M, editor. Practical Nephrology. Springer; 2014;291-5.
  4. Trostle DS, Bedetti CD, Steen VD, et. al. Renal vascular histology and morphometry in systemic sclerosis. A case-control autopsy study. //Arhritis Rheum. 1988;31:393-400. https://doi.org/10.1002/art.1780310311
  5. Steen VD, Medsger TA. Change in causes of death in systemic sclerosis, 1972–2002. /Ann Rheum Dis. 2007;66:940–4. https://doi.org/10.1136/ard.2006.066068
  6. Renal disease in systemic sclerosis. In: Tareev EM, editor. Osnovy nefrologii [Fundamentals of Nephrology]. Moscow: Meditsina; 1972;635-44. (In Russ.)
  7. Shanmugam VK, Steen VD. Renal manifestations in scleroderma: evidence for subclinical renal disease as a marker of vasculopathy. //Reumatol Int. 2010;2010:ID-538589.
  8. Yang Y, Liu T, Zhao J, et al. Warfarin-related nephropathy: prevalence, risk factors and prognosis. //Int J Cardiol. 2014;176:1297-8. https://doi.org/10.1016/j.ijcard.2014.07.166
  9. Bosch X, Poch E, Josep MG. Rhabdomyolysis and acute kidney injury. //N Engl J Med. 2009;361:62–72. https://doi.org/10.1056/NEJMra0801327
  10. Steen VD. Scleroderma renal crisis. Rheum /Dis Clin North Am. 2003;29:315. https://doi.org/10.1016/S0889-857X(03)00016-4
  11. Steen VD, Costantino JP, Shapiro AP, et al. Outcome of renal crisis in system sclerosis: relation to availability of angiotensin converting enzyme (ACE) inhibitors. //Ann Intern Med. 1990;113:352–67. https://doi.org/10.7326/0003-4819-113-5-352
  12. Walker UA, Tyndall A, Czijak L, et al. Clinical risk assessment of organ manifestation in systemic sclerosis: a report from the EULAR Scleroderm Trial and Research group database. //Ann Rheum Dis. 2007;66:754–63. https://doi.org/10.1136/ard.2006.062901
  13. Moore HC, Sheehan HL. The kidney of scleroderma. //Lancet. 1952;259(6698):68–70. https://doi.org/10.1016/S0140-6736(52)91798-4
  14. Shanmugam VK, Steen VD. Renal disease in scleroderma: an update on evaluation, risk stratification, pathogenesis and management. //Curr Opin Rheumatol. 2012 November;24(6):669–76. https://doi.org/10.1097/BOR.0b013e3283588dcf
  15. Penn H, Howie AJ, Kingdon EJ, et al. Scleroderma renal crisis: patient characteristics and long-term outcomes. //QJM. 2007;100:485–94. https://doi.org/10.1093/qjmed/hcm052
  16. Steen VD. Kidney involvement in systemic sclerosis. //La Presse Medicale. 2014;43(10):e305-14. https://doi.org/10.1016/j.lpm.2014.02.031
  17. Clements PJ, Lachenbruch PA, Furs DE, et al. Abnormalitis of renal physiology in systemic sclerosis. A prospective study with 10-year follow-up. //Arthritis Rheum. 1994;37:67–74. https://doi.org/10.1002/art.1780370110
  18. Teixeira L, Mouthon L, Mahr A, et al. Mortality and risk factors of scleroderma renal crisis: a French retrospective study of 50 patients. //Ann Rheum Dis. 2008;67(1):110–6. https://doi.org/10.1136/ard.2006.066985
  19. Qian Q. Thrombotic microangiopathy not associated with the classic/idiopathic TTP-HUS. Core concepts in parenchymal kidney disease. //New York: Springer; 2014;249-62.
  20. Sachin SS, Ronco C, Pophale R. Cardio-renal syndrome type 5: epidemiology, pathophysiology and treatment. Semin Nephrol. 2012;32:49–56. https://doi.org/10.1016/j.semnephrol.2011.11.007

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