Objectives: Study aim was to evaluate estimated glomerular filtration rate (eGFR), its association with clinical disease and its predictive ability with mortality in systemic sclerosis (SSc) patients from the European Scleroderma Trials and Research Group (EUSTAR) database. Methods: SSc patients from the EUSTAR database with available items for calculation of eGFR at baseline visit and with a second follow-up visit were included. A cut-off of 60 ml/min was chosen for all SSc patients and 30 ml/min for scleroderma renal crisis (SRC). Cox regression and competing risk analysis were performed to evaluate the role of eGFR as predictive factor of mortality. Results: 3650 SSc patients were included. Mean serum level of creatinine and eGFR were 0.8 mg/dl (IQR 0.6-0.9) and 86.6 ± 23.7 ml/min. The eGFR was significantly lower in patients with pulmonary hypertension. Overall survival (OS) was significantly reduced in SSc patients with eGFR <60 ml/min respect to patients with eGFR ≥ 60 ml/min [OS at five years 0.763 (CI 95%: 0.700-0.814) vs 0.903 (CI 95%: 0.883-0.919 p< 0.001)]. In multivariable analysis, OS was associate with male gender (p< 0.01), systolic pulmonary arterial pressure (sPAP) (p< 0.001) and eGFR (p< 0.001). Cumulative incidence of deaths due to SSc was associate with increased sPAP (p< 0.001) and reduced eGFR (p< 0.05). OS at five years of 53 SRC patients was not significantly different in SSc patients with eGFR > 30 ml/min or eGFR < 30 ml/min. Conclusion: eGFR represents a predictive risk factor of overall survival in SSc. The eGFR is not a risk factor for death in SRC.

Estimated glomerular filtration rate is a marker of mortality in the European Scleroderma Trials and Research Group (EUSTAR) database / Gigante, Antonietta; Hoffmann-Vold, Anna-Maria; Alunni Fegatelli, Danilo; Gabrielli, Armando; Leodori, Giorgia; Coleiro, Bernard; De Santis, Maria; Dagna, Lorenzo; Alegre-Sancho, Juan Jose; Montecucco, Carlomaurizio; Carreira, Patricia E; Balbir-Gurman, Alexandra; Doria, Andrea; Riemekasten, Gabriela; Airò, Paolo; Distler, Jörg; Distler, Oliver; Rosato, Edoardo; Eustar, Collaborators. - In: RHEUMATOLOGY. - ISSN 1462-0324. - (2021), pp. 1-10. [10.1093/rheumatology/keab302]

Estimated glomerular filtration rate is a marker of mortality in the European Scleroderma Trials and Research Group (EUSTAR) database

Gigante, Antonietta;Alunni Fegatelli, Danilo;Leodori, Giorgia;Rosato, Edoardo
;
2021

Abstract

Objectives: Study aim was to evaluate estimated glomerular filtration rate (eGFR), its association with clinical disease and its predictive ability with mortality in systemic sclerosis (SSc) patients from the European Scleroderma Trials and Research Group (EUSTAR) database. Methods: SSc patients from the EUSTAR database with available items for calculation of eGFR at baseline visit and with a second follow-up visit were included. A cut-off of 60 ml/min was chosen for all SSc patients and 30 ml/min for scleroderma renal crisis (SRC). Cox regression and competing risk analysis were performed to evaluate the role of eGFR as predictive factor of mortality. Results: 3650 SSc patients were included. Mean serum level of creatinine and eGFR were 0.8 mg/dl (IQR 0.6-0.9) and 86.6 ± 23.7 ml/min. The eGFR was significantly lower in patients with pulmonary hypertension. Overall survival (OS) was significantly reduced in SSc patients with eGFR <60 ml/min respect to patients with eGFR ≥ 60 ml/min [OS at five years 0.763 (CI 95%: 0.700-0.814) vs 0.903 (CI 95%: 0.883-0.919 p< 0.001)]. In multivariable analysis, OS was associate with male gender (p< 0.01), systolic pulmonary arterial pressure (sPAP) (p< 0.001) and eGFR (p< 0.001). Cumulative incidence of deaths due to SSc was associate with increased sPAP (p< 0.001) and reduced eGFR (p< 0.05). OS at five years of 53 SRC patients was not significantly different in SSc patients with eGFR > 30 ml/min or eGFR < 30 ml/min. Conclusion: eGFR represents a predictive risk factor of overall survival in SSc. The eGFR is not a risk factor for death in SRC.
2021
eustar; glomerular filtration rate; scleroderma renal crisis; systemic sclerosis
01 Pubblicazione su rivista::01a Articolo in rivista
Estimated glomerular filtration rate is a marker of mortality in the European Scleroderma Trials and Research Group (EUSTAR) database / Gigante, Antonietta; Hoffmann-Vold, Anna-Maria; Alunni Fegatelli, Danilo; Gabrielli, Armando; Leodori, Giorgia; Coleiro, Bernard; De Santis, Maria; Dagna, Lorenzo; Alegre-Sancho, Juan Jose; Montecucco, Carlomaurizio; Carreira, Patricia E; Balbir-Gurman, Alexandra; Doria, Andrea; Riemekasten, Gabriela; Airò, Paolo; Distler, Jörg; Distler, Oliver; Rosato, Edoardo; Eustar, Collaborators. - In: RHEUMATOLOGY. - ISSN 1462-0324. - (2021), pp. 1-10. [10.1093/rheumatology/keab302]
File allegati a questo prodotto
File Dimensione Formato  
Gigante_Estimated_2021.pdf

Open Access dal 23/03/2022

Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 492.63 kB
Formato Adobe PDF
492.63 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1558971
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 6
social impact