Renal Crisis and Other Renal Manifestations

Renal manifestations of systemic sclerosis include scleroderma renal crisis that manifests most often as acute kidney injury with accelerated hypertension in the context of systemic sclerosis. It was previously the most lethal complication of the disease but now can generally be successfully managed using angiotensin-converting enzyme inhibitors. Long-term outcomes remain poor for those patients that require long-term renal replacement therapy. Other forms of renal involvement include chronic kidney disease that has been shown to link to long-term survival and more acute renal complications occurring in the context of overlap syndromes such as vasculitis or SLE. Drug-induced kidney disease also needs to be considered.