Renal involvement in ankylosing spondylitis: a retrospective, population-based cohort study using data from the...

Area of Science:

• Rheumatology and Nephrology
• Epidemiology
• Clinical Research

Background:

• Renal involvement in ankylosing spondylitis (AS) is recognized but lacks comprehensive population-level data.
• Existing reports on kidney issues in AS are heterogeneous, ranging from minor urinalysis changes to severe outcomes like end-stage renal disease and malignancy.

Purpose of the Study:

• To quantify the incidence and risk of major kidney outcomes in AS patients compared to matched controls.
• To estimate the long-term occurrence of these renal outcomes.
• To investigate potential sex-specific differences in renal morbidity associated with AS.

Main Methods:

• A retrospective, population-based cohort study utilizing the TriNetX Global Collaborative Network.
• Propensity score matching was employed to compare adults with AS (1:1) against controls, considering demographics and comorbidities.
• Key outcomes included chronic kidney disease (CKD), acute kidney injury (AKI), dialysis, glomerular diseases, and others, analyzed using Cox models.

Main Results:

• Ankylosing spondylitis (AS) was linked to substantially elevated risks across a wide spectrum of renal outcomes.
• The hazard of developing chronic kidney disease (CKD) was more than doubled in the AS cohort (HR 2.51).
• Highest risks were observed for dialysis initiation (HR 7.58), followed by acute kidney injury (AKI) (HR 2.18) and glomerular diseases (HR 2.06).

Conclusions:

• Ankylosing spondylitis (AS) is associated with a significant, multifactorial increase in kidney-related morbidity.
• Routine nephrological surveillance should be integrated into rheumatology care pathways for AS patients.
• A multidisciplinary approach is essential for early detection and prevention of irreversible kidney damage.