Nefropatia por IgA em portadores de espondiloartrites acompanhados no Serviço de Reumatologia do Hospital das Clínicas da UFMG

Abstract

Objective: To determine the frequency of glomerulonephritis in patients with spondyloarthritis followed-up at a Brazilian Rheumatology Service, and to evaluate the clinical variables associated. Patients and methods: Patients were assessed for sociodemographic characteristics, type of spondyloarthritis, time since diagnosis and disease activity, non-steroidal anti-infl ammatory drug use, HLA-B27 positivity, creatinine and urea serum levels, major comorbidities, hematuria and proteinuria. Patients with hematuria were subsequently assessed for the presence of dysmorphic red blood cells in urine, and those with proteinuria underwent 24-hour urine protein measurement. Renal biopsy was performed in patients with glomerular hematuria and/or proteinuria over 3.5 g/24-hour. Results: Seventy-six patients were assessed. Microscopic hematuria was the most frequently found abnormality in urinalysis (44.7%), usually intermittent and in spot urine samples during patients' follow-up. In eight patients (10.5%), glomerular hematuria was suspected. Renal biopsy was performed in fi ve of them, showing IgA nephropathy in four (5.3%) and thin membrane disease in one patient. Conclusions: A high frequency of urinalysis alterations was observed in that subgroup of patients, as well as a high prevalence of IgA nephropathy. Although further studies on this subject are needed to better clarify these results, periodic urinalysis of patients with spondyloarthritis should be recommended.

HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy

“…However, univariate analysis of our study failed to indicate that gender was related to renal function decline. Lee et al and Azevedo et al reported no difference in frequency of proteinuria and hematuria between HLA-B27positive and -negative patients (15,16). In our study, the severity of hematuria, proteinuria secretion, and renal function were also similar between the two groups.…”

Kidney Disease in Ankylosing Spondylitis: a case series and review of the literature

“…In the past, AA amyloidosis was the most common diagnosis. More recently, a number of case series showed an increasing prevalence of IgAN 10 , 11 , 21 , mainly in Asian cohorts. Moreover, it has been suggested that SpA-IgAN may be associated with poorer renal outcomes compared to primary IgAN in Caucasian patients.…”

Spondyloarthritis Patients Suffer Increased Risk of Renal Complications Compared With General Population: A Retrospective Observational Study

“…In our study, urinary sediment analysis showed that most hematuria was of glomerular origin and renal pathology showed IgA nephropathy was of the predominant pathology type. One study conducted in Brazil showed that of the 24 patients assessed for the presence of dysmorphic erythrocytes, eight (33.3%) had glomerular hematuria while the others had mixed hematuria (Azevedo et al, 2011). Other studies reported that IgA nephropathy accounted for 38% and 33.3% (Lee et al, 2013; Wu et al, 2018), which showed that IgA nephropathy was the most common renal pathological type.…”