Clinical Analysis Of Renal Damage In Systemic Sclerosis

Objective:To retrospectively analyze the general characteristics,clinical manifestations and laboratory test results of patients with systemic sclerosis(SSc)complicated with renal damage,and to explore the risk factors of renal damage in SSc,so as to provide evidence for the early diagnosis and treatment of renal damage in SSc.Methods:A total of 58 patients with confirmed SSc who were hospitalized in the Second Hospital of Shanxi Medical University from January 1,2018 to December 30,2021 were included in this study.The patients were divided into SSc renal damage group and SSc non-renal damage group according to whether the renal damage was combined.The general data,clinical manifestations,and laboratory indexes between the two groups were statistically analyzed.Measurement data conforming to normal distribution were expressed as mean ± standard deviation,and t-test was used for comparison between two groups.The count data were expressed by frequency and percentage,and the comparison between the two groups was performed by the X2(chi-square)test.Measurement data conforming to non-normal distribution were expressed as median and interquartile range M(P25～P75),and Mann Whitney U test was used between two groups.P<0.05 indicated that the difference was statistically significant.Statistically significant variables were analyzed by orthogonal partial least squares discriminant analysis(OPLS-DA),and independent variables with VIP value greater than 1 were relatively important.The higher the VIP value,the better the predictor of kidney damage.Results:A total of 58 patients with SSc(18 males and 50 females)were included in this study,including 12 patients with renal damage and 46 patients without renal damage.Compared with SSc non-renal damage group,SSc renal damage group had a shorter average course of disease and a higher proportion of the history of hypertension,and the difference was statistically significant(P<0.05).The SSc renal damage group had more multi-system damage(heart,lung,blood system,nervous system),and the difference was statistically significant(P<0.05).The red blood cells,hemoglobin,total protein,e GFR,total T cells,Th cells,and Th17 cells in the SSc renal damage group were lower than those in the SSc non-renal damage group,and the difference was statistically significant(P<0.05).Kinase isoenzyme,lactate dehydrogenase,total bilirubin,serum creatinine,uric acid,blood urea nitrogen and calcium ion in the SSc renal damage group were higher than those in SSc non-renal damage group,and the difference was statistically significant(P<0.05).OPLS-DA discriminant analysis showed that e GFR,lactate dehydrogenase,blood urea nitrogen,uric acid,hemoglobin,and VIP value of cardiac involvement were greater than 1,suggesting that these factors were related to the pathogenesis of SSc renal damage.Conclusion:Glomerular filtration rate,lactate dehydrogenase,blood urea nitrogen,uric acid,hemoglobin,and cardiac involvement may be associated with the pathogenesis of renal damage in SSc.