Studies show that there is a relationship between illness or death (morbidity or mortality), scleroderma renal crisis (SRC), and a person’s race. A study using data from the U.S. Military Health System indicates that Black people are more at risk of SRC being severe than the risk that white people face. SRC is a complication of systemic scleroderma. The study appeared in Arthritis Care & Research.
Elevated blood pressure causes damage to kidneys, injury to blood vessels, and accelerated clotting. The progression is so rapid that the syndrome is called scleroderma renal crisis (SRC).
Symptoms of SRC may include congestive heart failure and high blood pressure (hypertension) leading to acute renal failure. SRC must be treated aggressively to prevent renal failure.
About the Study
Out of 294 patients with systemic scleroderma taking part in the study, 79 were Black. The patients who were affected were identified as being younger and mostly male when compared to the age and gender of other demographics.
Diagnosis of the systemic scleroderma cohort found that 16.5% of Black participants developed SRC compared to 7.4% of non-Black participants. When taking factors such as age and kidney function measures into consideration, researchers found that Black people represent at least six times the number of SRC cases in non-Black people.
There were, however, certain factors that appeared to be unrelated to race. These factors were elevated blood pressure or signs of proteinuria (a dysfunctional kidney).
Anti-Ro antibodies are commonly found in scleroderma patients. A significant percentage of Black patients (45%) who had SRC also had anti-Ro antibodies when compared to Black patients who did not have SRC (14%).
The same statistics for cancer, low platelets, and age, were not evident in non-Black participants.
SRC could be predicted by symptoms of cancer, low platelets, and age in non-Black patients but the same did not apply to the Black cohort.
The research team recommends that based on its findings, Black scleroderma patients who have anti-Ro antibody and protein in the urine (proteinuria) require monitoring for SRC.
Perhaps due to the design of the study, the researchers found it difficult to draw conclusions to any degree. They noted that understanding the racial predisposition of SRC when diagnosing systemic scleroderma is vital to the improvement of clinical surveillance and therapeutic intervention.
The researchers recommend further studies to identify the underlying mechanisms of SRC and determine the association between scleroderma and race.