HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy
This study aimed to determine the impact of HLA-B27 on clinical phenotype and renal function during follow-up periods in patients with ankylosing spondylitis (AS) and secondary IgA nephropathy (IgAN). This single-center retrospective study included 71 AS patients with secondary IgAN. Renal function...
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2020-04-01
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doaj-4bc75b4f63704709bcf8318a9cdd0c8d2020-11-25T02:09:53ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-04-01710.3389/fmed.2020.00089523390HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA NephropathyTi ZhangFan YangKe ZuoJinquan WangZhen ChengJiong ZhangThis study aimed to determine the impact of HLA-B27 on clinical phenotype and renal function during follow-up periods in patients with ankylosing spondylitis (AS) and secondary IgA nephropathy (IgAN). This single-center retrospective study included 71 AS patients with secondary IgAN. Renal function decline was defined as a mean eGFR decline of more than 5 mL/min/1.73 m2 per year or progression into the dialysis stage. The association between HLA-B27 status and renal function decline was evaluated by univariable and multivariable Cox regression analyses. The results showed that seven (9.85%) of the 71 included patients were HLA-B27-negative. The median follow-up period was 4.0 years. HLA-B27-negative patients showed higher levels of uric acid (UA) than those who were HLA-B27-positive. Pathologically, a higher percentage of globally sclerotic glomeruli was observed in HLA-B27-negative patients. Survival analysis indicated that HLA-B27 negativity was associated with a significantly higher probability of renal function decline than HLA-B27 positivity. This significant association was also found in subgroup analyses of patients with either substantial proteinuria (more than 1.0 g per day) or interstitial fibrosis and tubular atrophy. Multivariable analysis showed that HLA-27 negativity was independently associated with renal function decline (HR 6.58; 95% CI 1.65 to 26.21; p = 0.008). In conclusion, HLA-B27 negativity is associated not only with a higher level of UA and a higher percentage of globally sclerotic glomeruli in AS patients with secondary IgAN but with renal function decline during follow-up periods.https://www.frontiersin.org/article/10.3389/fmed.2020.00089/fullankylosing spondylitisIgA nephropathyHLA-B27outcomepathogenesis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ti Zhang Fan Yang Ke Zuo Jinquan Wang Zhen Cheng Jiong Zhang |
spellingShingle |
Ti Zhang Fan Yang Ke Zuo Jinquan Wang Zhen Cheng Jiong Zhang HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy Frontiers in Medicine ankylosing spondylitis IgA nephropathy HLA-B27 outcome pathogenesis |
author_facet |
Ti Zhang Fan Yang Ke Zuo Jinquan Wang Zhen Cheng Jiong Zhang |
author_sort |
Ti Zhang |
title |
HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy |
title_short |
HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy |
title_full |
HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy |
title_fullStr |
HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy |
title_full_unstemmed |
HLA-B27 Negativity Is Associated With Renal Function Decline in Patients With Ankylosing Spondylitis and Secondary IgA Nephropathy |
title_sort |
hla-b27 negativity is associated with renal function decline in patients with ankylosing spondylitis and secondary iga nephropathy |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2020-04-01 |
description |
This study aimed to determine the impact of HLA-B27 on clinical phenotype and renal function during follow-up periods in patients with ankylosing spondylitis (AS) and secondary IgA nephropathy (IgAN). This single-center retrospective study included 71 AS patients with secondary IgAN. Renal function decline was defined as a mean eGFR decline of more than 5 mL/min/1.73 m2 per year or progression into the dialysis stage. The association between HLA-B27 status and renal function decline was evaluated by univariable and multivariable Cox regression analyses. The results showed that seven (9.85%) of the 71 included patients were HLA-B27-negative. The median follow-up period was 4.0 years. HLA-B27-negative patients showed higher levels of uric acid (UA) than those who were HLA-B27-positive. Pathologically, a higher percentage of globally sclerotic glomeruli was observed in HLA-B27-negative patients. Survival analysis indicated that HLA-B27 negativity was associated with a significantly higher probability of renal function decline than HLA-B27 positivity. This significant association was also found in subgroup analyses of patients with either substantial proteinuria (more than 1.0 g per day) or interstitial fibrosis and tubular atrophy. Multivariable analysis showed that HLA-27 negativity was independently associated with renal function decline (HR 6.58; 95% CI 1.65 to 26.21; p = 0.008). In conclusion, HLA-B27 negativity is associated not only with a higher level of UA and a higher percentage of globally sclerotic glomeruli in AS patients with secondary IgAN but with renal function decline during follow-up periods. |
topic |
ankylosing spondylitis IgA nephropathy HLA-B27 outcome pathogenesis |
url |
https://www.frontiersin.org/article/10.3389/fmed.2020.00089/full |
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