Estimated glomerular filtration rate and renal resistive index as possible predictive markers of mortality in systemic sclerosis

Leodori, Giorgia; Pellicano, Chiara; Gigante, Antonietta; Rosato, Edoardo

doi:10.1016/j.ejim.2021.01.025

Cited by 7 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The background to this study is the established efficacy of selective and non-selective ERA in management of other major complications of SSc including pulmonary arterial hypertension [ 10 ]. In addition, bosentan is approved for management of digital ulcer disease [ 11 ]. In an earlier study, our group provided the rationale for targeting the endothelin axis in scleroderma renal disease and reported a small open label study of bosentan in patients that had suffered scleroderma renal crisis (SRC).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Zibotentan in systemic sclerosis-associated chronic kidney disease: a phase II randomised placebo-controlled trial

et al. 2022

View full text Add to dashboard Cite

Background We report results from a phase II randomised placebo-controlled trial assessing zibotentan, a highly selective endothelin receptor antagonist (ERA), in chronic kidney disease (CKD) secondary to systemic sclerosis (SSc). Methods This trial included three sub-studies: ZEBRA 1—a randomised placebo-controlled, double-blind trial of zibotentan in SSc patients with CKD2 or CKD3 (and glomerular filtration rate (GFR) >45 ml/min) over 26 weeks; ZEBRA 2A—a 26-week placebo-controlled, single-blind trial of zibotentan in scleroderma renal crisis patients not requiring dialysis; and ZEBRA 2B—an open label pharmacokinetic study of zibotentan in patients on haemodialysis. Results Sixteen patients were screened for ZEBRA 1. Of these, 6 patients were randomised to zibotentan and 7 to placebo. In ZEBRA 1, there were 47 non-serious adverse events (AE) during the trial. Twenty-seven occurred in the placebo group and 20 in the zibotentan group. One serious adverse event (SAE) occurred during ZEBRA1, in the placebo arm. Descriptive statistics did not suggest an effect of study drug on serum sVCAM1. Estimated GFR numerically declined in patients treated with placebo at 26 weeks and 52 weeks. In contrast, average eGFR increased in zibotentan-treated cases. The 4 patients in ZEBRA 2A experienced 8 non-serious AEs, distributed equally between placebo and zibotentan. There was one SAE each in placebo and zibotentan groups, both unrelated to study medication. ZEBRA 2B recruited 8 patients, 6 completed first dosing, and 2 completed a second dosing visit. Pharmacokinetic analysis confirmed zibotentan levels within the therapeutic range. Three patients experienced 3 non-serious AEs. One SAE occurred and was unrelated to study drug. Conclusions Zibotentan was generally well-tolerated. ZEBRA 1 did not show any effect of zibotentan on serum sVCAM-1 but was associated with numerical improvement in eGFR at 26 weeks that was more marked at 52 weeks. ZEBRA 2B suggested a feasible dose regimen for haemodialysis patients. Trial registration EudraCT no: 2013-003200-39 (first posted January 28, 2014) ClinicalTrials.gov Identifier: NCT02047708 Sponsor protocol number: 13/0077

show abstract

Section: Discussionmentioning

confidence: 99%

“…A recent study of 5 pooled cohorts reported that around one fifth of SSc patients had eGFR of less than 60ml/min [ 9 ]. CKD has been shown to predict poor outcome in SSc [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Zibotentan in systemic sclerosis-associated chronic kidney disease: a phase II randomised placebo-controlled trial

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Systemic sclerosis is an autoimmune disease affecting internal organs and skin by inflammation, vascular dysfunction and fibrosis [129]. The vasculopathy in systemic sclerosis includes pulmonary arterial hypertension, peripheral cutaneous artery disease with Raynaud's phenomenon, ulcers or gangrene and renal arterial disease [129,130]. RRI is a noninvasive ultrasound parameter able to diagnose early renal impairment in systemic sclerosis, before irreversible structural arterial changes occur [130].…”

Section: Rri Interaction With Other Diseasesmentioning

confidence: 99%

“…The vasculopathy in systemic sclerosis includes pulmonary arterial hypertension, peripheral cutaneous artery disease with Raynaud's phenomenon, ulcers or gangrene and renal arterial disease [129,130]. RRI is a noninvasive ultrasound parameter able to diagnose early renal impairment in systemic sclerosis, before irreversible structural arterial changes occur [130]. An RRI greater than 0.7 correlates with a longer duration of the disease and an increased risk for the occurrence of digital ulcers [129].…”

Section: Rri Interaction With Other Diseasesmentioning

confidence: 99%

“…An RRI greater than 0.7 correlates with a longer duration of the disease and an increased risk for the occurrence of digital ulcers [129]. More than that, pulmonary hypertension in systemic sclerosis is associated with renal dysfunction [129,130]. A high RRI and low GFR favor a three-fold increase risk of mortality in these patients [129].…”

Section: Rri Interaction With Other Diseasesmentioning

confidence: 99%

See 1 more Smart Citation

Current Insights into Renal Resistive Index Significance in Kidney and Cardiovascular Disease

Darabont¹,

Mihalcea²,

Vinereanu³

2023

Preprint

View full text Add to dashboard Cite

Initially, renal resistive index (RRI) was investigated to improve diagnosis in kidney diseases, but failed to meet this goal. Recently many papers highlighted the prognostic significance of RRI in chronic kidney disease, in the estimation of revascularization success of renal artery stenoses or the evolution of the graft and recipients in renal transplantation. Moreover, RRI gained importance in prediction of acute kidney injury in critically ill patients. Along with RRI study in renal pathology have been revealed correlations of this index with parameters of systemic circulation. The theoretical and experimental premises of this connection were reconsidered, and studies for analyzing the link between RRI and arterial stiffness, central and peripheral pressure or left ventricular flow were conducted with this purpose. A high amount of data is currently indicating that RRI is influenced more by pulse pressure and vascular compliance than by renal vascular resistance – assuming that RRI reflects the complex interplay between systemic circulation and renal microcirculation and should be considered as a marker of systemic cardiovascular risk beyond its prognostic relevance for kidney disease. In this review we will go through clinical research that revealed the implications of RRI in renal and cardiovascular disease.

show abstract

Systemic Vasospasm

Hummers

2024

Raynaud’s Phenomenon

View full text Add to dashboard Cite

Estimated glomerular filtration rate and renal resistive index as possible predictive markers of mortality in systemic sclerosis

Cited by 7 publications

References 29 publications

Zibotentan in systemic sclerosis-associated chronic kidney disease: a phase II randomised placebo-controlled trial

Zibotentan in systemic sclerosis-associated chronic kidney disease: a phase II randomised placebo-controlled trial

Current Insights into Renal Resistive Index Significance in Kidney and Cardiovascular Disease

Systemic Vasospasm

Contact Info

Product

Resources

About