Cardiac manifestations in systemic sclerosis

Table 3 Criteria for definition of hypertensive scleroderma renal crisis

In the presence of limited or diffuse cutaneous scleroderma renal crisis:

A new onset of blood pressure > 150/85 mmHg obtained at least twice over a 24 h period. This blood pressure is defined as significant hypertension by the New York Heart Association

A documented decrease in renal function as defined by a decrement of at least 30% in the calculated glomerular filtration rate. When possible, initial results should be confirmed by a repeat serum creatinine concentration and recalculation of the glomerular filtration rate

To corroborate further the occurrence of acute renal crisis, it would be desirable to have any of the following (if available):

Microangiopathic hemolytic anemia on blood smear

Retinopathy typical of acute hypertensive crisis

New onset of urinary red blood cells (excluding other causes)

Flash pulmonary edema

Oliguria or anuria

Renal biopsy showing characteristic changes

Renal biopsy showing an alternative cause excludes the case from classification as scleroderma renal crisis