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Systematic Review of Kidney Involvement in Antisynthetase Syndrome
Qi-Shun Wu1, Ling Yang1, Xin Lin1
1Division of Nephrology, Department of Medicine, The Second Affiliated Hospital of Wannan Medical University, Wuhu, Anhui, China.
Kidney International Reports
|July 13, 2026
Summary
Antisynthetase syndrome (ASyS) rarely involves the kidneys, but when it does, specific autoantibodies may indicate worse outcomes. Early kidney surveillance and targeted immunosuppression are recommended for better patient prognosis.
Area of Science:
- Nephrology
- Rheumatology
- Autoimmune Diseases
Background:
- Antisynthetase syndrome (ASyS) is a rare autoimmune condition characterized by autoantibodies against aminoacyl-tRNA synthetases.
- Kidney involvement in ASyS is infrequently documented and poorly understood.
Purpose of the Study:
- To systematically review and characterize kidney involvement in ASyS.
- To identify common kidney pathologies and evaluate treatment outcomes in ASyS patients with renal manifestations.
Main Methods:
- A systematic review adhering to PRISMA 2020 guidelines was performed.
- Searches were conducted across major databases (MEDLINE, Scopus, Web of Science, Google Scholar) up to January 2026.
- Included studies focused on adults with biopsy-proven or clinically diagnosed kidney involvement in ASyS, with risk of bias and certainty of evidence assessed.
Main Results:
- The review included 38 articles with 52 ASyS patients exhibiting kidney disease, often concurrent with interstitial lung disease (81%).
- Common kidney pathologies included membranous nephropathy (29%), pauci-immune crescentic glomerulonephritis (23%), and acute tubular necrosis (17%).
- Non-Jo1 antibodies were linked to worse kidney function (higher peak creatinine) compared to anti-Jo1 antibodies, and rituximab showed efficacy in refractory cases.
Conclusions:
- Kidney involvement in ASyS is clinically significant and warrants attention.
- Non-Jo1 serotypes may predict poorer kidney outcomes, necessitating further investigation.
- Routine renal surveillance and prompt, antibody-guided immunosuppressive therapy are suggested to improve patient outcomes.
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