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Timely renal transplantation for scleroderma end-stage kidney disease patients can improve outcomes and quality of life.

Indication for and timing of renal transplantation for systemic sclerosis (SSc) patients who require renal replacement therapy (RRT) as a result of scleroderma end-stage kidney disease (ESKD) is controversial. We recently published a review of scleroderma renal crisis (SRC) and renal involvement in SSc that included an examination of outcomes of RRT, and the role and timing of renal transplantation in SSc patients who become dialysis-dependent as result of ESKD (1). In our review of 10 articles published between 1990 and 2015 the vast majority of patients experienced SRC, with 1–5% of patients found to have ANCA-associated vasculitis or microangiopathic hemolytic anemia (1).