Scleroderma renal crisis

Unlabeled Uses Diabetic nephropathy, hypertension due to scleroderma renal crisis, hypertensive crisis, idiopathic edema, renal artery stenosis, rheumatoid arthritis, post Ml for prevention of ventricular failure... 

The administration of glucocorticoids should be undertaken with caution in progressive systemic sclerosis and the concomitant administration of anticoagulants to prevent scleroderma renal crisis is recommended when administering glucocorticoids in high doses, especially by pulse therapy (SEDA-21, 415 150). 

Yamanishi Y, Yamana S, Ishioka S, Yamakido M. Development of ischemic colitis and scleroderma renal crisis following methylprednisolone pulse therapy for progressive systemic sclerosis. Intern Med 1996 35(7) 583-6. 

Lam M, Ballou SP. Reversible scleroderma renal crisis after cocaine use. N Engl J Med 1992 326(21) 1435. 

Attoussi S, FaulknerML,Oso A, Umoru B. Cocaine-induced scleroderma and scleroderma renal crisis. South Med J 1998 91 961-963. 

Steen VD, Medsger TA Jr. Case-control study of corticosteroids and other drugs that either precipitate or protect from the development of scleroderma renal crisis. Arthritis Rheum 1998 41(9) 1613-1619. 

Urinary tract Scleroderma renal crisis (SRC) is one of the most feared complications of systemic sclerosis (SSc). It is characterised by acute renal failure usually accompanied by malignant hypertension. SRC has been associated with the use of CS in retrospective studies. An evidence-based systematic review was done by Canadian researchers [27 ]. They identified 26 prospective studies which included a total of 500 (81% women) SSc pafients, in which CS were administered as a new indication. The objective was to ascertain the risk of SRC in newly treated patients. Ten definite SRC cases were reported among the 500 patients, equivalent to a rate of 2%, out of which, eight had received pulse CS tiierapy (initial doses greater than 30 mg per day of prednisone equivalent), two medium doses of CS (initial doses between 16 and 30 mg per day of prednisone equivalent) and none low-dose CS. Considering only the 11 studies limited to early diffuse SSc patients, they identified nine definite SRC cases in 226 patients, which is equivalent to a rate of 4%. This study provides additional support for the association between CS and SRC previously reported in retrospective studies but does not eliminate the possibility that the association may be due to confounding by disease severity or by co-intervention. 

Trang G, Steele R, Baron M, Hudson M. Corticosteroids and the risk of scleroderma renal crisis a systematic review. Rheumatol Int March 2012 32(3) 645-53. 

Unlabeled Uses Treatment of diabetic and nondiabetic nephropathy, post-MI ieft ven-tricuiar dysfunction, renal crisis in scleroderma... 

Unlabeled Uses Treatment of hypertension and renal crisis in scleroderma, treatment of leff venfricular dysfunction following MI... 

Shortly after starting dexfenfluramine 30 mg/day, an 18-year-old woman died of sclerodermal renal crisis (91). Although there have been reports linking longterm fenfluramine use and the development of scleroderma (92,93), this is perhaps the first report implicating dexfenfluramine. 

Treatment of hypertension alone or in combination with other antihypertensives. Adjunctive therapy for CHF (in combination with cardiac glycosides, diuretics). Treatment of diabetic nephropathy, hypertension, or renal crisis in scleroderma. Half-life 11 hours Onset PO 1 hour IV 15 minutes Peaks PO Duration PO 4-6 hours 24 hours IV 1 1 IV 6 hours hours... 

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