The Kidney in Progressive Systemic Sclerosis

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Abstract
Nine normotensive progressive systemic sclerosis patients with normal renal function underwent renal biopsy. Four specimens had prominent vascular abnormalities, 2 mild vascular abnormalities, and 3 were normal. Vascular deposits of C3 [complement component 3] were present in all specimens. Plasma renin activity was elevated in 3 of 4 patients with prominent vascular abnormalities, 1 or 2 patients with mild vascular lesions, and 0 of 2 patients with normal biopsies. Plasma renin activity elevation in response to cold pressor testing in the 4 patients with prominent vascular lesions was 5.6 ng/ml per h compared to 0.55 ng/ml per h in those with mild or no lesions and 0.26 ng/ml per h in 6 control subjects. Renal vascular lesions may be present in normotensive patients. Elevation or a substantial rise in plasma renin activity (1.8 ng/ml per h or greater) in response to cold pressor testing suggests preclinical renal involvement.

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