Spectrums and Prognosis of Kidney Disease in Patients with Ankylosing Spondylitis

Abstract

Background/Aims: Renal involvement was a common extra-articular manifestation of ankylosing spondylitis (AS). Few reports have investigated the pathological characteristics and renal outcomes of AS patients with kidney disease. The aim of this study was to investigate the pathological spectrums and the renal prognosis of AS patients with kidney disease. Methods: This retrospective and observational study was conducted working on 62 patients (47 males and 15 females) with a diagnosis of AS (ACR, 1984) and renal biopsies between 2008 and 2017. The histopathological findings and associated clinical manifestations were collected, and the renal prognoses of patients with kidney disease were evaluated too. Multivariate binary logistic regression analysis was performed to identify risk factors for the occurrence of IgA nephropathy (IgAN). Results: Renal biopsy revealed that IgAN accounted for a majority (74.2%) of the kidney disease with AS, while membranous nephropathies, minimal change disease, focal segmental glomerulosclerosis, and other lesions accounted for a small minority. Multivariate analysis revealed that serum immunoglobulin A >3.45 g/L and immunoglobulin G >9.06 g/L were risk factors for the occurrence of IgAN. With a median follow-up time of 24.3 months, 28 patients (50.9%) reached complete remission, 9 patients (16.4%) had partial remission, and 1 patient had an eGFR decline >30%. No difference was found in prognosis between IgAN and non-IgAN. Conclusion: IgAN occurred in 76.4% of the kidney disease with AS, and higher serum immunoglobulin A and G increased the risk for the occurrence of IgAN. The renal prognosis of kidney disease in AS was good.

Journal

Journal ID (publisher-id): KDD

Journal ID (pmc): KDD

Journal ID (doi): 10.1159/issn.2296-9357

Title: Kidney Diseases

Publisher: S. Karger AG

ISSN (Print): 2296-9381

ISSN (Electronic): 2296-9357

Publication date Subscription-year: 2020

Publication date (Print): November 2020

Publication date (Electronic): 26 August 2020

Volume: 6

Issue: 6

Pages: 444-452

Affiliations

_aNational Clinical Research Center of Kidney Disease, Jinling Medical College of Nanjing Medical University, Najing, China

_bNephrology Department, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Yangzhou, China

_cNational Clinical Research Center of Kidney Disease, Jinling Medical College of Nanjing University, Najing, China

Author notes

*Zheng Tang, National Clinical Research Center of Kidney Disease, Jinling Medical College of Nanjing Medical University, 305 East Zhong Shan Road, Nanjing 210002 (China), [e-mail]

Article

Publisher ID: 509248 Other ID: Kidney Dis 2020;6:444–452

DOI: 10.1159/000509248

Copyright statement: © 2020 The Author(s). Published by S. Karger AG, Basel

License:

This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Page count

Tables: 6, Pages: 9

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Categories

Subject: Research Article