{
  "abstract": "Introduction Renal failure in the context of Scleroderma Renal Crisis (SRC) has been extensively studied as a complication of Systemic Sclerosis (SS). However, scarce data is available on the ability of SS patients’ kidneys to manage common renal injuries, such as sepsis. We examined the incidence and etiologies of acute kidney injury (AKI) episodes in our cohort of SS patients and their implication on renal function.Material and Methods Medical files of SS patients registered at Rambam hospital from 2003 till 08/2024 were screened for episodes of AKI. Renal function was evaluated using creatinine clearance (CCT, Cockroft-Gault formula) or eGFR (CKD-EPI formula, 2021). CCT and eGFR decline rates were calculated for each patient. When an episode of AKI was identified, eGFR slope of decline was compared before and after that episode.Results Of 460 SS patients screened for renal abnormalities 30 were identified. 3 of them had chronic renal failure prior to SS diagnosis and the rate of decline in CCT was comparable to that expected in general population. 24 patients presented with AKI: 7 with SRC, 2 with P-ANCA vasculitis, 1 with bisphosphonate related acute tubular necrosis (ATN), 9 with cardio-renal mechanism, 5 with hypotension and sepsis. Fifty percent of these patients fully recovered with no residual abnormalities or effect on CCT rate of decline. SRC, P-ANCA vasculitis, and cardio-renal etiologies were associated with accelerated rate of kidney function decline following an AKI episode. 3 patients with severe pulmonary hypertension (PHT) and Cor pulmonale didn’t suffer from acute or chronic renal failure but exhibited accelerated CCT decline preceding their decease.Conclusions Half patients with SS demonstrated preserved renal capacity to manage common renal injuries with full restoration of renal function following an AKI episode. The subsequent rate of CCT decline was not longitudinally altered in these patients. Accelerated decline in renal function in patients with heart failure or PHT could serve an ominous harbinger of worsening prognosis.",
  "authors": [
    {
      "affiliations": [
        "B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel"
      ],
      "name": "Katya Dolnikov"
    },
    {
      "affiliations": [
        "B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel",
        "Rappaport Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa, Israel"
      ],
      "name": "Alexandra Balbir-Gurman"
    },
    {
      "affiliations": [
        "B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel",
        "Rappaport Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa, Israel"
      ],
      "name": "Kochava Toledano"
    },
    {
      "affiliations": [
        "B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel"
      ],
      "name": "Yonit Tavor"
    },
    {
      "affiliations": [
        "B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel"
      ],
      "name": "Sami Giryes"
    },
    {
      "affiliations": [
        "Department of Nephrology and Hypertension, Rambam Health Care Campus, Haifa, Israel",
        "Rappaport Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa, Israel"
      ],
      "name": "Suheir Assady"
    },
    {
      "affiliations": [
        "B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel",
        "Rappaport Faculty of Medicine, Technion-Israeli Institute of Technology, Haifa, Israel"
      ],
      "name": "Yolanda Braun-Moscovici"
    }
  ],
  "title": "P.072 Acute kidney injury and its implication on kidney function in patients with systemic sclerosis",
  "uid": "3c9b262b-1151-52fe-b43e-038440029fea"
}