Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Int J Rheum Dis. 2024 Aug;27(8):e15310. doi: 10.1111/1756-185X.15310.
Ankylosing spondylitis (AS) predominantly affects the spine and sacroiliac joints, with rare renal involvement. We investigated the incidence rate and risk factors for chronic kidney disease (CKD) in patients with AS and its relationship with long-term nonsteroidal anti-inflammatory drug (NSAID) use.
We retrospectively analyzed data of patients diagnosed with AS from the Korean National Health Insurance service. The 3-month, 6-month, and 1-year Assessment of SpondyloArthritis International Society (ASAS) NSAID Intake Scores were categorized into four groups, as follows: =0, >0 and ≤33.3, 33.3-66.6, and >66.6.
Of the 12 000 patients with AS, 150 were identified with CKD, and the incidence rate was 4.64 per 10 000 patient-years. Factors significantly associated with CKD included age ≥60 years, Charlson Comorbidity Index, hypertension, and diabetes mellitus. In the nested case-control analysis, among the ASAS NSAIDs Intake Scores for 0-365 days from diagnosis, the ≥66.6 group had a significantly lower odds ratio than those of the =0 group.
The present study established the incidence rate of CKD in Korean patients with AS. Though older age and comorbidities were found to be associated with a higher CKD risk, long-term NSAID use was associated with a lower risk. Therefore, the optimal use of NSAIDs in inflammatory diseases requires extensive research.
强直性脊柱炎（AS）主要影响脊柱和骶髂关节，罕见肾脏受累。我们研究了 AS 患者慢性肾脏病（CKD）的发病率和危险因素及其与长期使用非甾体抗炎药（NSAID）的关系。
我们回顾性分析了韩国国家健康保险服务中诊断为 AS 的患者数据。将 3 个月、6 个月和 1 年的评估强直性脊柱炎国际协会（ASAS）非甾体抗炎药摄入评分分为四组：=0、>0 且≤33.3、33.3-66.6 和>66.6。
在 12000 名 AS 患者中，有 150 名患者患有 CKD，发病率为每 10000 患者年 4.64 例。与 CKD 显著相关的因素包括年龄≥60 岁、Charlson 合并症指数、高血压和糖尿病。在巢式病例对照分析中，从诊断开始至 0-365 天的 ASAS NSAIDs 摄入量评分中，≥66.6 组的比值比明显低于=0 组。
本研究确定了韩国 AS 患者 CKD 的发病率。虽然年龄较大和合并症与更高的 CKD 风险相关，但长期 NSAID 使用与较低的风险相关。因此，需要对炎症性疾病中 NSAIDs 的最佳使用进行广泛研究。
