J Korean Med Sci.  2018 Jul;33(30):e188. 10.3346/jkms.2018.33.e188.

Gender Is a Risk Factor for Annual Decline in Estimated Glomerular Filtration Rate in Patients Treated with Biological DMARDs in Rheumatoid Arthritis and Ankylosing Spondylitis: a Retrospective Observational Study

• Kim SK
• Choe JY

• KMID: 2418431
• DOI: http://doi.org/10.3346/jkms.2018.33.e188

Abstract

BACKGROUND
This study identified the risk factors of changes in renal function in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) treated with biological disease-modifying anti-rheumatic drugs (bDMARDs).
METHODS
We retrospectively enrolled patients with RA (n = 293) and AS (n = 125) treated with bDMARDs. The estimated glomerular filter rate (eGFR) using the Modification of Diet in Renal Disease equation was applied for assessment of annual changes in renal function between initiation and last visit after bDMARD therapy. The annual change in eGFR was used as an indicator for change in renal function. Statistical significance was assessed by Mann-Whitney test, Spearman's correlation coefficient, and multivariate linear regression analysis.
RESULTS
The positive annual change in eGFR in women was significantly noted, compared to that in men (P = 0.004). The annual change in eGFR was different between men and women (P = 0.038) in RA, but not in AS patients (P = 0.126). In multivariate linear regression analysis, women patients and increased serum creatinine at baseline were closely associated with positive annual change in eGFR in both RA and AS patients. In RA patients, younger age and lower ESR level were considered risk factors of positive annual change in eGFR (P = 0.013 and P = 0.022, respectively). However, disease duration and duration of bDMARD use were not associated with annual change in eGFR.
CONCLUSION
This study found that gender, especially men, might be responsible for annual decline in eGFR in RA and AS patients treated with bDMARDs.

Keyword

Rheumatoid Arthritis; Ankylosing Spondylitis; bDMARDs; Renal Function; eGFR

MeSH Terms

Antirheumatic Agents*
Arthritis, Rheumatoid*
Creatinine
Diet
Female
Glomerular Filtration Rate*
Humans
Linear Models
Male
Observational Study*
Retrospective Studies*
Risk Factors*
Spondylitis, Ankylosing*
Antirheumatic Agents
Creatinine