• Cosimo Bruni, Edoardo Rosato, Vanessa Maestripieri, Antonietta Gigante, Giulia Tesei, Silvia Bellando-Randone, Serena Guiducci, Marco Chiostri, Khadija El Aoufy, Jelena Blagojevic, Alberto Moggi-Pignone, Amato De Paulis, Daniel E Furst, Maria Boddi, and Marco Matucci-Cerinic.
• Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Via Delle Oblate 4, 50134 Florence, Italy; Department Cardio-Thorax-Vascular Medicine, Division of General Cardiology, Azienda Ospedaliera Universitaria Careggi, Florence, Italy. Electronic address: cosimobruni85@gmail.com.
• Eur. J. Intern. Med. 2019 Dec 1; 70: 43-49.

BackgroundRenal Resistive Index (RRI), reflects changes in both renal vascular and tubular-interstitial compartments and in systemic vascular compliance related to age and comorbidities.Objectivesa) To investigate determinants of RRI in SSc population, b) its association with SSc-related features and c) to test its prognostic impact on organ specific worsening or death.Methods380 SSc patients ≥18 years were enrolled after giving informed consent. Baseline data on RRI, laboratory, instrumental and therapeutic features were retrospectively collected. Age-SSc adjusted cut-offs were created by dividing the population in age quartiles and considering RRI values >75th percentile as pathologic. Clinical follow-up was performed until last available visit or the development/worsening of specific internal organ involvement or death.ResultsRRI was independently predicted by age and systolic pulmonary arterial pressure on Echo. Therefore, we created Age-SSc adjusted pathologic RRI cut-offs, which were significantly associated with various disease related skin and lung fibrotic manifestations, as well as vasculopathic complications. After a mean follow-up of 3.6 ± 2.6 years, RRI was one of the independent predictors (together with modified Rodnan skin score, interstitial lung disease, presence of dyspnoea and late nailfold-videocapillaroscopy pattern) for mortality, with 0.68 as best cut-off (sensitivity 88.5%, specificity 50.9%).ConclusionIf corroborated, Renal Resistive Index cut-offs might be used to evaluate renal and extrarenal involvement in SSc and could serve as predictors of mortality.Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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