Tonsawan P, et al. - Researchers performed the first historical cohort study on adult Thai systemic sclerosis (SSc) patients who underwent a renal biopsy during January 2005–December 2016, appraising the renal pathological diagnosis and its clinical feature among these adults. They identified 26 SSc patients (77% female) including 46% with the diffuse cutaneous SSc subtype. The most common renal manifestation was rapidly progressive glomerulonephritis (RPGN) (53.9%) followed by nephrotic syndrome (19.2%) and nephritis (11.5%). Lupus nephritis (LN) class IV (26.9%), LN class V (19.2%), scleroderma renal crisis (SRC; 19.3%), progressive renal disease in scleroderma (7.7%), and IgA nephropathy (7.7%) were the pathological diagnosis made. The most common renal feature among LN class V patients was the nephrotic syndrome, whereas, among LN class IV and SRC patients, RPGN was the commonest renal presentation. Relative to the other groups, SRC patients underwent significantly higher dialysis treatment at the time of kidney biopsy. The SRC vs the other groups were more likely to have cardiac involvement, pulmonary fibrosis, and shorter disease duration.