Abstract: PO0016
Association of Race and Risk of Future Scleroderma Renal Crisis at Systemic Sclerosis Diagnosis
Session Information
- AKI Epidemiology, Risk Factors, and Prevention: Clinical Research
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Forman, Crystal, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, Texas, United States
- Olson, Stephen W., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Gordon, Sarah M., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Hughes, James Bradford, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Stitt, Rodger S., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Bailey, Wayne, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Edison, Jess D., Walter Reed National Military Medical Center, Bethesda, Maryland, United States
- Nee, Robert, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
Background
Scleroderma renal crisis (SRC) is a rare and severe manifestation of systemic sclerosis (SSc). Although it is well documented that Blacks with SSc have worse morbidity and mortality than non-Blacks, racial predilection for SRC is underreported. We examine the association of race and future development of SRC in an SSc cohort.
Methods
Using the electronic medical record of the U.S. Military Health System which consisted of 9.6 million beneficiaries worldwide, we conducted a comprehensive chart review of each patient with SSc from 2005 to 2016 (see flowchart). The final study cohort was comprised of 31 SRC cases and 322 SSc without SRC controls. We conducted logistic regression of SRC as the outcome variable and race (Black vs. non-Black) as the primary predictor variable, adjusted for age, estimated glomerular filtration rate (eGFR), hypertension and proteinuria at SSc diagnosis.
Results
Out of 353 patients, 294 had identifiable race (79 Black, 215 non-Black). Thirteen out of 79 Blacks (16.5%) vs. 16/215 (7.4%) non-Blacks developed SRC (p=0.02). Black SRC patients were younger (47 ± 12 vs. 57 ± 13 years, p=0.04) and had a higher eGFR at baseline (93 ± 30 vs. 61 ± 17 ml/min/1.73m2, p=0.003) than their non-Black counterparts. Other baseline clinical and laboratory characteristics were comparable between the 2 racial groups with SRC. On adjusted analysis, Blacks had a significantly higher risk of developing SRC than non-Blacks (odds ratio 6.4, 95% CI 1.3-31.2, p=0.02).
Conclusion
Black race was independently associated with a higher risk of future SRC. Future studies are needed to elucidate the mechanisms that underlie this important association.
Flowchart of study participants. EMR: electronic medical record; ICD-9: International Classification of Diseases, 9th Revision; SRC: scleroderma renal crisis; SSc: systemic sclerosis.