Abstract
BackgroundAnkylosing spondylitis (AS) is a well-known male-predominant inflammatory disease. This study aimed to assess the gender disparity in chronic kidney disease (CKD) in AS patients in China.MethodsAS patients were retrospectively studied at Peking Union Medical College hospital between January 2002 and June 2018.ResultsAmong 616 patients with AS, 154 (25.0%) patients had CKD (age, 41.8 ± 14.2 years; male:female, 3.2:1). Overall, 80 (13.0%) patients had only microscopic hematuria, 62 (10.1%) had proteinuria with or without hematuria, and 33 (5.4%) exhibited a reduced estimated glomerular filtration rate (eGFR, ≤60 mL/min/1.73 m2). Male CKD patients had more frequent proteinuria (p < 0.01), less microscopic hematuria only (p < 0.01), and lower eGFR (p = 0.04) compared with females. CKD was independently associated with hyperuricemia and total cholesterol in females, and with hyperuricemia, hypertension, and serum albumin in males. After follow-up for 1–7 years, five patients required renal replacement therapy including two patients who were already at stage 5 CKD when enrolled and three patients whose creatinine doubled. One patient died in the male group. No patients in the female group showed progression of renal dysfunction.ConclusionsCKD is a common comorbidity in patients with AS. Male patients are more likely to develop severe manifestations compared with female patients. Hyperuricemia was a strong independent risk factor for CKD in both genders, while hypertension and low serum albumin were risk factors for CKD only in males.
Highlights
Ankylosing spondylitis (AS) is a well-known male-predominant inflammatory disease
The manifestations of renal involvement seem to be more severe in males compared with females, the prevalence of chronic kidney disease (CKD) was similar
The presence of hyperuricemia was a strong predictor of renal involvement for both genders of AS patients, while hypertension and low serum albumin are specific predictors for CKD only in male patients
Summary
Ankylosing spondylitis (AS) is a well-known male-predominant inflammatory disease. This study aimed to assess the gender disparity in chronic kidney disease (CKD) in AS patients in China. Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that primarily involves the spine and sacroiliac joints. Renal involvement in patients with AS has been attributed to multiple factors, including the use of nephrotoxic medication, the presence of comorbidities such as hypertension, and complications [4, 16, 17]. Few studies have investigated the gender disparity of CKD manifestation and prognosis or have focused on the risk factors for CKD in AS. This study was designed to evaluate the possible contribution of gender to differences in clinal features, disease progression, and risk factors of CKD in AS
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