Evaluation of microalbuminuria in patients with systemic sclerosis as an indicator of early renal damage and increased morbidity

ABSTRACT

Renal involvement and systemic vascular damage have been shown to be significantly affecting prognosis in systemic sclerosis. Microalbuminuria detection in SSc patients as an indicator of early renal involvement and its correlation with various SSc clinical, laboratory parameters and severity of organ systems' damage assessed by Scleroderma Assessment Questionnaire. Forty SSc patients [33 females and 7 males] with mean age of 27.48 +/- 12.56 years and mean disease duration of 6.2 +/- 4.14 years were included. Twenty-four [60%] had lSSc; 13 [32.5%] had dSSc and 3 [7.5%] patients had SSc sine scleroderma. Eight [20%] had microalbuminuria and 9 [22.5%] patients had decreased creatinine clearance. Albumin/creatinine ratio was significantly higher among dSSc patients compared to those with lSSc and SSc sine scleroderma [X[2] = 9.077; p = 0.01]. Albumin/creatinine ratio showed significant positive correlations with telangiectasia [r = 0.322; p = 0.04] and mRodnan's skin score [r = 0.352; p = 0.026] and negative correlations with inter-incisor distance [r = -0.525; p = 0.001] and pleurisy [r = -0.446; p = 0.004]. Albumin/creatinine ratio correlated significantly and positively with IMSS and IDS indices of SAQ [r = 0.378, 0.32; p = 0.016, 0.044, respectively]. SSc patients with microalbuminuria showed significantly higher mean IDS than those without [1.058 vs. 0.631, p = 0.04]. No statistically significant correlations were found between creatinine clearance and the different demographic, clinical features and the indices of SAQ. Microalbuminuria compared to creatinine clearance may be a more sensitive indicator of early renal affection and predictor of increased morbidity