The Renal Resistive Index: A New Biomarker for the Follow-up of Vascular Modifications in Systemic Sclerosis.

Abstract

OBJECTIVE:

The aim of the present retrospective observational study was to evaluate the change of Renal Resistive Index (RRI) over time (ΔRRI) and under treatment in patients with systemic sclerosis (SSc) as well as to correlate these changes with disease complications.

METHODS:

Two hundred thirty patients [29 male, median age 57 (IQR 48-67) yrs] were enrolled. At baseline and follow-up (3.43, IQR 2.81-4.45 yrs), we collected the following data: disease variables, nailfold videocapillaroscopy (NVC) pattern, forced vital capacity (FVC), diffusing lung capacity for carbon monoxide (DLCO), systolic pulmonary arterial pressure (sPAP), presence of interstitial lung disease, RRI, evaluation of glomerular filtration rate, and new onset of pulmonary arterial hypertension (PAH).

RESULTS:

RRI value is high in SSc patients with digital ulcers and anticentromere antibodies, active and late NVC patterns, and limited cutaneous SSc. A significant correlation was observed between ΔRRI and ΔsPAP (R = 0.17, P = 0.02), with statistically higher ΔRRI (0.08 ± 0.02 vs 0.03 ± 0.05, P = 0.04) in patients complicated by PAH onset. No other new-onset complication was associated with ΔRRI. The receiver-operating characteristic curve analysis confirmed the predictive role of ΔRRI in development of new PAH (area under the curve 0.84, 95% CI 0.75-0.93, P = 0.02). In patients with SSc never exposed to sildenafil, ΔRRI was higher (0.04 ± 0.05) compared to both patients exposed to sildenafil during the study period (0.01 ± 0.05, P = 0.03) or in those exposed at the time of baseline evaluation (0.00 ± 0.05, P = 0.01).

CONCLUSION:

RRI and its variation in time are a reliable marker of SSc-related vasculopathy, both in renal and extrarenal compartments.

• Authors: Antonietta Gigante, Cosimo Bruni, Gemma Lepri, Giulia Tesei, Vanessa Maestripieri, Serena Guiducci, Alberto Moggi-Pignone, Daniela Melchiorre, Maria Boddi, Silvia Bellando-Randone, Edoardo Rosato, Marco Matucci-Cerinic
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 48 Issue 2 Pg. 241-246 (02 2021) ISSN: 0315-162X [Print] Canada
• PMID: 32238514 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2021 by the Journal of Rheumatology.

Chemical References

• Biomarkers

Topics

• Biomarkers
• Follow-Up Studies
• Humans
• Lung Diseases, Interstitial
• Male
• Microscopic Angioscopy
• Middle Aged
• Scleroderma, Systemic (complications, diagnostic imaging)