Manitoba Nephrology Nurse Practice Test

What characterizes Scleroderma in relation to kidney function?

1. Fluid overload and swelling

2. Connective tissue proliferation leading to glomerular ischemia

3. Degeneration of renal tubular cells

4. Autoimmune attack on renal arteries

The correct answer is: Connective tissue proliferation leading to glomerular ischemia

Scleroderma is a systemic disease characterized primarily by fibrosis and vasculopathy affecting the skin and internal organs, including the kidneys. In relation to kidney function, a key aspect is the proliferation of connective tissue which leads to glomerular ischemia. This condition causes renal blood flow reduction due to the thickening of vascular walls and narrowing of the blood vessels, negatively impacting glomerular perfusion and, consequently, kidney function. The pathology behind this involves fibrotic changes that can occur in various organ systems as a result of chronic inflammation and autoimmune processes. Such changes lead to impaired filtration capabilities of the kidneys, which can manifest as renal insufficiency or even kidney crisis. The other options describe phenomena that aren't the primary issues associated with scleroderma and kidney function. Fluid overload and swelling represent typical signs of renal failure, but they do not address the underlying mechanism of disease in scleroderma. Degeneration of renal tubular cells may occur in various kidney diseases but is not specifically linked to scleroderma. An autoimmune attack on renal arteries is more characteristic of other types of vasculitis rather than the predominant pathophysiological changes seen in scleroderma. Thus, the correct choice accurately reflects the significant relationship between connective