| [ Summary ] |
Although the frequency of scleroderma renal crisis (SRC) in Japanese patients with systemic sclerosis (SSc) is lower than that in Caucasian patients with SSc, SRC is an important complication that determines prognosis. Since angiotensin-converting enzyme in hibitors (ACEI) were first applied to SRC in 1979, the prognosis for SRC has improved dramatically. Nonetheless, it has heen reported that 27% of SRC patients receiving early ACEI treatment died and that 16% of those patients required permanent dialysis. It has heen emphasized that early diagnosis and treatment are important to improve the prognosis for SRC patients. In this respect, it is important to know the risk factors for developing SRC. Patients who have recently hecome hypertensive should immediately receive ACEI to normalize blood pressure. Patients with a deterioration in renal function require dialysis. Patients on dialysis should continue to receivelow doses of ACEI because it is considered to promote normalization of renal function. |