NORMOTENSIVE SCLERODERMA RENAL CRISIS: CLINICAL CHALLENGES IN DIAGNOSIS AND MANAGEMENT (A CLINICAL CASE)

Abstract

One of the highly lethal complications of systemic sclerosis (SSc) is a scleroderma renal crisis (SRC). The classic manifestations of this condition include a sudden malignant increase in blood pressure (BP) and progressive renal failure along with autoimmune damage of the renal vascular endothelium. A special case of acute kidney injury in SSc is normotensive scleroderma renal crisis (NSRC). The frequency of this complication does not exceed 20 % of all cases of SКС with a limited form of SSc, but NSRC has an extremely poor prognosis (mortality rate of more than 60 %, the increasing need for patients in chronic hemodialysis, kidney transplantation). Despite progressive renal failure, BP remains within the normal range, which makes it difficult to diagnose this complication in due time. It is known that one of the risk factors for the development of NSRC is long -term use of high doses of glucocorticosteroids. To correct this condition, treatment strategies developed for classical SRC are used. maintaining optimal blood pressure, prescribing nephroprotective drugs. Renal replacement therapy if necessary. The article presents a clinical case of acute kidney injury in a patient suffering from SSc with lung and liver damage during glucocorticosteroid therapy.