Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study

© 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd Introduction: Data regarding the prevalence, risk factors and outcome of scleroderma renal crisis (SRC) in Asian patients with systemic sclerosis (SSc) are limited. Objective: To determine the prev...

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Main Authors: Suparaporn Wangkaew, Supawita Lertthanaphok, Saowanee Puntana, Kajohnsak Noppakun
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/47045
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spelling th-cmuir.6653943832-470452018-04-25T07:37:29Z Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study Suparaporn Wangkaew Supawita Lertthanaphok Saowanee Puntana Kajohnsak Noppakun Agricultural and Biological Sciences Arts and Humanities © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd Introduction: Data regarding the prevalence, risk factors and outcome of scleroderma renal crisis (SRC) in Asian patients with systemic sclerosis (SSc) are limited. Objective: To determine the prevalence, risk factors and outcomes of SRC in Thai SSc patients. Method: Medical records of all SSc patients seen at the Division of Rheumatology, Chiang Mai University, Thailand, from January 1990 to December 2015 were retrospectively reviewed. For each SRC case, a disease duration (±1 year) matched control (four SSc patient without SRC for each SRC patient) was identified. Result: Of 608 SSc patients seen during the study period, 19 SRC cases were identified, resulting in an SRC prevalence of 3.13%, with 76 matched controls. Of the 19 cases, mean ± SD age and median (interquartile range 1–3) disease duration was 56.2 ± 13.8 years and 5 (3–22) months, respectively. Seventeen patients (89.5%) had diffuse cutaneous SSc. Twelve patients (63.2%) had hypertensive renal crisis and seven (36.8%) had normotensive renal crisis. Multivariate conditional logistic regression analyses showed that digital gangrene (adjusted odd ratio [AOR] 31.41, 95% CI = 1.16–852.23, P = 0.041), current prednisolone dose ≥ 15 mg/day (AOR 31.22, 95% CI = 1.59–613.85, P = 0.024), serum albumin < 3 mg/dL (AOR 7.97, 95% CI = 1.49–42.56, P = 0.015), and cardiac involvement (AOR = 6.62, 95% CI = 1.08–40.63, P = 0.041) were independent risk factors for SRC. Fifteen SRC patients (78.9%) required dialysis and 10 (52.6%) died. Conclusion: SRC was an uncommon complication in Thai patients with SSc, but is associated with high mortality. Digital gangrene, current prednisolone dose ≥ 15 mg/day, serum albumin < 3 mg/dL and cardiac involvement were independent risk factors for SRC. 2018-04-25T07:15:35Z 2018-04-25T07:15:35Z 2017-10-01 Journal 1756185X 17561841 2-s2.0-85026307142 10.1111/1756-185X.13145 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85026307142&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/47045
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Agricultural and Biological Sciences
Arts and Humanities
spellingShingle Agricultural and Biological Sciences
Arts and Humanities
Suparaporn Wangkaew
Supawita Lertthanaphok
Saowanee Puntana
Kajohnsak Noppakun
Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study
description © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd Introduction: Data regarding the prevalence, risk factors and outcome of scleroderma renal crisis (SRC) in Asian patients with systemic sclerosis (SSc) are limited. Objective: To determine the prevalence, risk factors and outcomes of SRC in Thai SSc patients. Method: Medical records of all SSc patients seen at the Division of Rheumatology, Chiang Mai University, Thailand, from January 1990 to December 2015 were retrospectively reviewed. For each SRC case, a disease duration (±1 year) matched control (four SSc patient without SRC for each SRC patient) was identified. Result: Of 608 SSc patients seen during the study period, 19 SRC cases were identified, resulting in an SRC prevalence of 3.13%, with 76 matched controls. Of the 19 cases, mean ± SD age and median (interquartile range 1–3) disease duration was 56.2 ± 13.8 years and 5 (3–22) months, respectively. Seventeen patients (89.5%) had diffuse cutaneous SSc. Twelve patients (63.2%) had hypertensive renal crisis and seven (36.8%) had normotensive renal crisis. Multivariate conditional logistic regression analyses showed that digital gangrene (adjusted odd ratio [AOR] 31.41, 95% CI = 1.16–852.23, P = 0.041), current prednisolone dose ≥ 15 mg/day (AOR 31.22, 95% CI = 1.59–613.85, P = 0.024), serum albumin < 3 mg/dL (AOR 7.97, 95% CI = 1.49–42.56, P = 0.015), and cardiac involvement (AOR = 6.62, 95% CI = 1.08–40.63, P = 0.041) were independent risk factors for SRC. Fifteen SRC patients (78.9%) required dialysis and 10 (52.6%) died. Conclusion: SRC was an uncommon complication in Thai patients with SSc, but is associated with high mortality. Digital gangrene, current prednisolone dose ≥ 15 mg/day, serum albumin < 3 mg/dL and cardiac involvement were independent risk factors for SRC.
format Journal
author Suparaporn Wangkaew
Supawita Lertthanaphok
Saowanee Puntana
Kajohnsak Noppakun
author_facet Suparaporn Wangkaew
Supawita Lertthanaphok
Saowanee Puntana
Kajohnsak Noppakun
author_sort Suparaporn Wangkaew
title Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study
title_short Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study
title_full Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study
title_fullStr Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study
title_full_unstemmed Risk factors and outcome of Thai patients with scleroderma renal crisis: a disease duration-matched case control study
title_sort risk factors and outcome of thai patients with scleroderma renal crisis: a disease duration-matched case control study
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85026307142&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/47045
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