Gordon et al identified risk factors for scleroderma renal crisis at the time of scleroderma diagnosis. These can help to identify a patient who may benefit from more aggressive management.
Patient selection: systemic sclerosis at the time of diagnosis
Predictors of scleroderma renal crisis:
(1) proteinuria (odds ratio 183)
(2) anemia (odds ratio 9.9)
(3) hypertension (odds ratio 13.1)
(4) chronic kidney disease (odds ratio 20.7)
(5) elevated ESR (odds ratio 14.3)
(6) thrombocytopenia (odds ratio 7)
(7) hypothyroidism (odds ratio 2.8)
(8) anti-Ro antibody (odds ratio 3.9)
(9) anti-RNA polymerase III antibodies (ARA) (odds ratio 4.1)
where:
• Several of these findings represent existing renal disease.
total number of risk factors =
= SUM(number of conditions present)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 0
• The presence of >= 3 risk factors showed 77% sensitivity and 97% specificity for future scleroderma renal crisis.
