SKLERODERMIJSKA BUBREŽNA KRIZA

Jadranka Morović-Vergles, Melanie Ivana Čulo, Dušanka Martinović Kaliterna

Systemic sclerosis (SSc) is a multisystem disease whose clinical manifestations result from infl ammation, vascular injury and obliteration, and cutaneous and visceral fibrosis. Scleroderma renal crisis (SRC) occurs in 5% of patients with particullary diffuse form of SSc. It is characterized by malignant hypertension and oligo/anuric acute renal failure. SRC was once a uniformly fatal complication of SSc. The prognosis of SRC has significantly improved with the introduction of angiotensin-converting enzyme inhibitors (ACEi) as treatment. The treatment of SRC relies on tight control of blood pressure and aggressive treatment with ACEi, if needed in combination with other types of antihypertensive drugs.

Sistemska skleroza (SSc) sustavna je bolest nepoznatog uzroka čija su glavna obilježja krvožilne i fibrozne promjene kože i unutarnjih organa. Skerodermijska bubrežna kriza (SBK) javlja se u oko 5% bolesnika s najčešće difuznim oblikom SSc, a očituje se malignom hipertenzijom i oligo/anuričnim akutnim bubrežnim zatajenjem. Prognoza SBK je znatno bolja nakon otkrića i primjene inhibitora enzima konvertaze angiotenzina I (ACE-inhibitora). Liječenje sklerodermijske bubrežne krize zasniva se na redovitim kontrolama krvnog tlaka i agresivnom liječenju hipertenzije primjenom ACE-inhibitora uz dodatak, ako je potrebno, drugih antihipertenzivnih lijekova.