Scleroderma Renal Crisis

Here's a nice visual for diagnosis and treatment of systemic sclerosis renal crisis. For diagnosis just think of a patient who has systemic sclerosis who has a new AKI, HTN with a normal urinalysis/urine sediment (but may have mild proteinuria), and signs of MAHA. Usually it is diagnosed within the first 4 years after diagnosis of diffuse cutaneous SSc. For treatment, Captain Captopril comes to save the day. You bring the blood pressure back to normal within 72 hours. His side-kick nitroprusside helps when there is CNS involvement of the renal crisis (eg encephalopathy, papilledema).