Kidney Dysfunction in Spondyloarthritis

May 16, 2018

Which patients with spondyloarthritis are at greatest risk for renal impairment?

Reference1. Couderc M, Pereira B, Molto A, et al. The prevalence of renal impairment in patients with spondyloarthritis: results from the International ASAS-COMOSPA Study. J Rheumatol. 2018 Apr 15. pii: jrheum.170133. doi: 10.3899/jrheum.170133. [Epub ahead of print]

Couderc and colleagues¹ in Paris, France, investigated comorbidities in spondyloarthritis (SpA) via the Assessment of Spondyloarthritis International Society-COMOrbidities in SPondyloArthritis (ASAS-COMOSPA) study. They found that renal dysfunction was associated with older age, HLA-B27 positivity, and inflammation but not with cardiovascular (CV) risk factors, disease severity, or nonsteroidal anti-inflammatory drug (NSAID) use.

Scroll through the slides for the details of the study and the take-home points for physicians.

(Image credit: ©Radu Bercan/Shutterstock.com)

In addition, the higher incidence of CV risk factors in SpA may influence potential renal impairment.

ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; ESR, erythrocyte sedimentation rate.

After multivariate analysis, the following remained significantly associated with renal impairment in SpA: age older than 45 years, HLA-B27 positivity, and C-reactive protein (CRP) level.

Of note, after multivariate analysis, disease activity, CV risk factors, and all markers of inflammation except CRP became insignificant.

The bottom line for your practice: Risk factors for renal impairment in patients with spondyloarthritis include older age, HLA-B27 positivity, and elevated C-reactive protein. Special care should be taken with patients who are receiving nephrotoxic treatments, such as NSAIDs.