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Research ArticleSystemic Sclerosis

The Renal Resistive Index: A New Biomarker for the Follow-up of Vascular Modifications in Systemic Sclerosis

Antonietta Gigante, Cosimo Bruni, Gemma Lepri, Giulia Tesei, Vanessa Maestripieri, Serena Guiducci, Alberto Moggi-Pignone, Daniela Melchiorre, Maria Boddi, Silvia Bellando-Randone, Edoardo Rosato and Marco Matucci-Cerinic
The Journal of Rheumatology February 2021, 48 (2) 241-246; DOI: https://doi.org/10.3899/jrheum.191101
Antonietta Gigante
1A. Gigante, MD, E. Rosato, MD, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome;
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Cosimo Bruni
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Gemma Lepri
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Giulia Tesei
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Vanessa Maestripieri
3V. Maestripieri, MD, M. Boddi, MD, Department Cardio-Thorax-Vascular Medicine, Division of General Cardiology, Azienda Ospedaliera Universitaria Careggi, Florence;
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Serena Guiducci
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Alberto Moggi-Pignone
4A. Moggi-Pignone, MD, Department of Internal Medicine, Division of Internal Medicine Unit III, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
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Daniela Melchiorre
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Maria Boddi
3V. Maestripieri, MD, M. Boddi, MD, Department Cardio-Thorax-Vascular Medicine, Division of General Cardiology, Azienda Ospedaliera Universitaria Careggi, Florence;
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Silvia Bellando-Randone
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Edoardo Rosato
1A. Gigante, MD, E. Rosato, MD, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome;
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  • ORCID record for Edoardo Rosato
  • For correspondence: edoardo.rosato@uniroma1.it
Marco Matucci-Cerinic
2C. Bruni, MD, G. Lepri, MD, G. Tesei, MD, S. Guiducci, MD, D. Melchiorre, MD, S. Bellando-Randone, MD, M. Matucci-Cerinic, MD, Department of Experimental and Clinical Medicine, University of Florence, and Division of Rheumatology AOUC & Scleroderma Unit, Florence;
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Abstract

Objective. The aim of the present retrospective observational study was to evaluate the change of Renal Resistive Index (RRI) over time (ΔRRI) and under treatment in patients with systemic sclerosis (SSc) as well as to correlate these changes with disease complications.

Methods. Two hundred thirty patients [29 male, median age 57 (IQR 48–67) yrs] were enrolled. At baseline and follow-up (3.43, IQR 2.81–4.45 yrs), we collected the following data: disease variables, nailfold videocapillaroscopy (NVC) pattern, forced vital capacity (FVC), diffusing lung capacity for carbon monoxide (DLCO), systolic pulmonary arterial pressure (sPAP), presence of interstitial lung disease, RRI, evaluation of glomerular filtration rate, and new onset of pulmonary arterial hypertension (PAH).

Results. RRI value is high in SSc patients with digital ulcers and anticentromere antibodies, active and late NVC patterns, and limited cutaneous SSc. A significant correlation was observed between ΔRRI and ΔsPAP (R = 0.17, P = 0.02), with statistically higher ΔRRI (0.08 ± 0.02 vs 0.03 ± 0.05, P = 0.04) in patients complicated by PAH onset. No other new-onset complication was associated with ΔRRI. The receiver-operating characteristic curve analysis confirmed the predictive role of ΔRRI in development of new PAH (area under the curve 0.84, 95% CI 0.75–0.93, P = 0.02). In patients with SSc never exposed to sildenafil, ΔRRI was higher (0.04 ± 0.05) compared to both patients exposed to sildenafil during the study period (0.01 ± 0.05, P = 0.03) or in those exposed at the time of baseline evaluation (0.00 ± 0.05, P = 0.01).

Conclusion. RRI and its variation in time are a reliable marker of SSc-related vasculopathy, both in renal and extrarenal compartments.

Key Indexing Terms:
  • renal Doppler ultrasonography
  • renal resistive index
  • systemic sclerosis
  • vasculopathy
  • Accepted for publication March 20, 2020.
  • Copyright © 2021 by the Journal of Rheumatology
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The Renal Resistive Index: A New Biomarker for the Follow-up of Vascular Modifications in Systemic Sclerosis
Antonietta Gigante, Cosimo Bruni, Gemma Lepri, Giulia Tesei, Vanessa Maestripieri, Serena Guiducci, Alberto Moggi-Pignone, Daniela Melchiorre, Maria Boddi, Silvia Bellando-Randone, Edoardo Rosato, Marco Matucci-Cerinic
The Journal of Rheumatology Feb 2021, 48 (2) 241-246; DOI: 10.3899/jrheum.191101

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The Renal Resistive Index: A New Biomarker for the Follow-up of Vascular Modifications in Systemic Sclerosis
Antonietta Gigante, Cosimo Bruni, Gemma Lepri, Giulia Tesei, Vanessa Maestripieri, Serena Guiducci, Alberto Moggi-Pignone, Daniela Melchiorre, Maria Boddi, Silvia Bellando-Randone, Edoardo Rosato, Marco Matucci-Cerinic
The Journal of Rheumatology Feb 2021, 48 (2) 241-246; DOI: 10.3899/jrheum.191101
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Keywords

renal Doppler ultrasonography
RENAL RESISTIVE INDEX
SYSTEMIC SCLEROSIS
VASCULOPATHY

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Keywords

  • renal Doppler ultrasonography
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  • systemic sclerosis
  • vasculopathy

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