ALTERATION OF RENAL PERFUSION IN NORMOTENSIVE PATIENTS WITH SCLERODERMA: A DUPLEX ULTRASONOGRAPHY STUDY

S.M. Weiner, K. Renoulet , N. Pham , L. Sellin , O. Vonend , A. Kreuter , L.C. Rump Medizinische Klinik I, Marienhospital Herne, Ruhr University Bochum, Herne, Dermatology, St. Josef Hospital, Ruhr University Bochum, Bochum, GermanyObjectives: The study evaluated the intrarenal vascular resistance by duplex ultrasonography in patients with progressive systemic sclerosis (PSS).Methods: Fifty nine patients with PSS were investigated. Ninety eight patients with other connective tissue diseases (CTD) served as controls (SLE: n=69; primary antiphospholipid syndrome: n=5; primary Sjogren's syndrome: n=9; undifferentiated connective tissue diseases: n=5). 80 patients (51%) had hypertension (28 patients with PSS, mean age 64 years; 52 patients with other CTD, mean age 56 years), 77 patients were normotensive (31 patients with PSS, mean age 53 years; 43 patients with other CTD, mean age 42 years). Intrarenal restance indices (RI) were measured in 3 segmental and 3 interlobar arteries by duplex ultrasonography. The RI values were adjusted to age and blood pressure: Delta RI was calculated as the difference between the mean intrarenal RI value of the indivual patient and the age-matched mean RI of healthy volunteers with or without hypertension.Results: Normotensive patients with PSS had a significantly higher delta RI (11.2±5.1) compared with normotensive patients with other CTD (4.5±3.7), p<0.0001. No difference in the delta RI was observed in hypertensive patients with PSS (-0.9±6.9) and other CTD (0.6±7.8), p=0.38. Proteinuria and/or elevated serum creatinine were detected in 4 PSS patients with normotension (13%) and 9 PSS patients with hypertension (32%).Conclusion: The elevated doppler indices of renal vascular resistance in normotensive patients with PSS suggest an altered renal perfusion in absence of obvious renal involvement.Citation: Ann Rheum Dis, volume 65, supplement II, year 2006, page 530Session: Scleroderma and related syndromes