Kidney Involvement in Spondyloarthritis: A Literature Review

Introduction. Currently, the identification and prevention of renal dysfunction in patients with spondyloarthritis receive insufficient attention, although kidney involvement can significantly determine their prognosis. The aim of this review is to analyze the types, prevalence, and risk factors for the development and progression of renal impairment in spondyloarthritis. Materials and methods. A search for publications was conducted in the PubMed database using keywords for the period 2000–2024. Preference was given to original research, systematic reviews, and meta-analyses. Particular attention was paid to studies including kidney biopsy data, as well as works devoted to long-term patient follow-up. In addition, reference lists of review articles were examined to identify relevant publications. Ultimately, 66 studies were included in the review. Results. Kidney involvement is a frequent complication of spondyloarthritis. The most common manifestations are AA amyloidosis, immunoglobulin A nephropathy, and chronic interstitial nephritis. Furthermore, patients are characterized by a significant prevalence and a greater risk of developing chronic kidney disease. High disease activity and duration, the presence of extra-articular manifestations, patient sex and age, time of diagnosis, the presence of human leukocyte antigen B27, and the levels of C-reactive protein, uric acid, immunoglobulins A and G, and albumin may indicate a high risk of kidney involvement. The use of non-steroidal anti-inflammatory drugs, certain synthetic and biological disease-modifying antirheumatic drugs may be associated with the development of kidney diseases, particularly in the presence of risk factors such as pre-existing renal dysfunction and hypertension. Metabolic disorders have a significant impact on the development and progression of renal dysfunction. Kidney dysfunction, in turn, affects adipose tissue function and the progression of metabolic disorders. Discussion and conclusion. Routine examination of patients with spondyloarthritis is necessary to detect kidney involvement, as well as to identify and correct factors contributing to the development and progression of renal dysfunction in this patient group.