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Clinically significant renal involvement in primary Sjögren's syndrome is associated with important morbidity: data from the Spanish Sjögrenser cohort


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

 

  1. Department of Rheumatology, Hospital Universitario de Bellvitge, Barcelona, Spain.
  2. Unidad de Investigación, Sociedad Española de Reumatología, Madrid, Spain.
  3. Department of Rheumatology, Hospital Puerto de Hierro, Madrid, Spain.
  4. Department of Rheumatology, Hospital Marqués de Valdecilla, Santander, Spain.
  5. Department of Rheumatology, Hospital Germans Trias i Pujol, Barcelona, Spain.
  6. Department of Rheumatology, Hospital Marina Baixa, Alicante, Spain.
  7. Department of Rheumatology, Hospital de la Princesa, Madrid, Spain.
  8. Rheumatology Unit, Hospital de Albacete, Spain.
  9. Department of Rheumatology, Hospital de Basurto, Vizcaya, Spain.
  10. Department of Rheumatology, Hospital Virgen de las Nieves, Granada, Spain.
  11. Department of Rheumatology, Hospital Santa Maria, Lleida, Spain.
  12. Department of Rheumatology, Hospital Puerto de Hierro, Madrid, Spain.

on behalf of the Sjögrenser Study Group

CER13903
2020 Vol.38, N°4 ,Suppl.126
PI 0116, PF 0124
Clinical aspects

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PMID: 33095138 [PubMed]

Received: 07/08/2020
Accepted : 17/09/2020
In Press: 22/10/2020
Published: 22/10/2020

Abstract

OBJECTIVES:
To investigate the prevalence, associated factors, and effects of primary overt renal disease on morbidity in patients with primary Sjögren’s syndrome (pSS).
METHODS:
All patients in the Sjögrenser (registry of adult pSS patients of the Spanish Society of Rheumatology) cohort were retrospectively investigated for the presence of clinically significant renal involvement directly related to pSS activity.
RESULTS:
Of the 437 patients investigated, 39 (9%) presented overt renal involvement during follow-up. Severe renal disease necessitating kidney biopsy was relatively rare (2%). Renal involvement may complicate pSS at any time during the disease course and is associated with severe disease (indicated by higher scores of involvement, activity, and damage), systemic multiorgan involvement, and a higher frequency of lymphoma. Multivariate analysis showed that older age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.00–1.07), higher European League Against Rheumatism Sjögren’s Syndrome Disease Activity Index scores (OR 1.1, CI 1.03–1.18), serum anti-La/SSB positivity (OR 6.65, CI 1.41–31.372), and non-vasculitic cutaneous involvement (OR 5.47, 1.03-29.02) were independently associated with this complication. Chronic renal failure developed in 23 of 39 patients (59%); only 1 of them progressed to end-stage renal disease necessitating renal replacement therapy. Patients with overt renal disease showed higher Sjögren’s syndrome disease damage index scores, higher rates of hospitalisation due to disease activity and higher rates of clinically relevant comorbidities.
CONCLUSIONS:
Overt renal involvement in pSS is not uncommon. Although it usually shows a favourable prognosis, is associated with significant morbidity.

Rheumatology Article

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