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The Kidney in Progressive Systemic Sclerosis: A Prospective Study

[+] Article and Author Information

Grant support: in part by a National Institutes of Health grant to the University of Colorado General Clinical Research Center (5M01 RR00051-16). Dr. Kovalchik is supported by a research fellowship grant from the Rocky Mountain Kidney Foundation.

This paper was presented in part at the Western Section, American Federation for Clinical Research 1978 meeting, and an abstract of it appeared in Clinical Research 26:122A, 1978.

▸Requests for reprints should be addressed to James C. Steigerwald, M.D.; Division of Rheumatic Diseases, University of Colorado Medical Center, 4200 E. 9th Ave., Box B115; Denver, CO 80262.

Denver, Colorado

© 1978 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1978;89(6):881-887. doi:10.7326/0003-4819-89-6-881
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Nine normotensive progressive systemic sclerosis patients with normal renal function underwent renal biopsy. Four specimens had prominent vascular abnormalities, two mild vascular abnormalities, and three were normal. Vascular deposits of C3 were present in all specimens. Plasma renin activity was elevated in three of four patients with prominent vascular abnormalities, one of two patients with mild vascular lesions, and none of two patients with normal biopsies. Plasma renin activity elevation in response to cold pressor testing in the four patients with prominent vascular lesions was 5.6 ng/ml · h compared to 0.55 ng/ml · h in those with mild or no lesions and 0.26 ng/ml · h in six control subjects. These data indicate that renal vascular lesions may be present in normotensive patients. Elevation or a substantial rise in plasma renin activity (1.8 ng/ml · h or greater) in response to cold pressor testing suggests preclinical renal involvement.





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