The Prevalence of Renal Impairment in Patients with Spondyloarthritis: Results from the International ASAS-COMOSPA Study

Autor: Maxime Dougados, Anna Molto, Marion Couderc, Aurélien Tiple, Martin Soubrier, Bruno Pereira
Přispěvatelé: Imagerie Moléculaire et Stratégies Théranostiques - Clermont Auvergne (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Université Paris Descartes - Paris 5 (UPD5), CHU Cochin [AP-HP], Université Sorbonne Paris Cité (USPC), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Department of Clinical Research and Innovation (DRCI), CHU Clermont-Ferrand, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], CHU Clermont-Ferrand, Service de rhumatologie [Clermont-Ferrand], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Rok vydání: 2017
Předmět:
Zdroj: Journal of Rheumatology
Journal of Rheumatology, Journal of Rheumatology Publishing Company Limited, 2018, 45 (6), pp.795-801. ⟨10.3899/jrheum.170133⟩
Journal of Rheumatology, 2018, 45 (6), pp.795-801. ⟨10.3899/jrheum.170133⟩
ISSN: 0315-162X
1499-2752
DOI: 10.3899/jrheum.170133⟩
Popis: Objective.To assess the prevalence and association of renal dysfunction in patients with spondyloarthritis (SpA).Methods.The ASAS-COMOSPA (Assessment of Spondyloarthritis international Society-COMOrbidities in SPondyloArthritis) was an international study (22 participating countries from 4 continents) investigating comorbidities in SpA. Renal function was assessed based on estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease equation. SpA characteristics and risk factors for renal impairment were collected. Nonsteroidal antiinflammatory drug (NSAID) use was assessed based on current intake (last 3 mos).Results.Of the 3984 patients recruited, 2098 (52.6%) were analyzed after excluding outliers and patients with no available eGFR measurement [male sex: 63.5%; age: 45.3 yrs; disease duration: 8.6 years; HLA-B27+: 73.1%; Bath Ankylosing Spondylitis Activity Index (BASDAI): 3.6/10]. Overall, 153 patients (5.2%, mean age: 53.6 yrs) exhibited an eGFR < 60 ml/min/1.73 m2. In univariate analysis, renal impairment was associated with age (p < 0.001), HLA-B27 positivity (p = 0.003), several cardiovascular (CV) risk factors (history of hypertension, p < 0.001; systolic blood pressure, p = 0.009; diabetes, p = 0.005; and Framingham risk score, p < 0.001), disease activity scores [BASDAI, p = 0.001; Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP), p < 0.001], functional variables (Bath Ankylosing Spondylitis Functional Index, p < 0.001), inflammatory biomarkers (erythrocyte and CRP, both p < 0.001), and NSAID intake since onset of disease (percentage of days, p = 0.008). However, there was no association with disease duration, disease severity, or ASAS-NSAID score. In multivariate analysis, age (45–59 yrs: OR 1.9, > 60 yrs: OR 6.2), HLA-B27 positivity (OR 0.51), and CRP (OR 1.3) remained significantly associated with eGFR < 60 ml/min/1.73 m2.Conclusion.Renal impairment was associated with age, HLA-B27 positivity, and inflammation, though not with CV risk factors, disease severity, or NSAID intake in patients with SpA.
Databáze: OpenAIRE