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.
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.
