Pathologic alterations of the heart and the kidney in patients with ankylosing spondylitis.

BACKGROUND

The occurrence of a variety of pathological lesions of the heart and kidneys have been described in patients with ankylosing spondylitis (AS). The frequency of these alterations and whether they are specific for AS has been discussed controversially. -

METHODS

Outpatients with AS were studied to determine the frequency of cardiac and renal alterations and to assess the associated clinical and demographic factors. -

RESULTS

A total of 77 patients with AS participated in the study (male 84.4%, mean age 48.3 +/- 1.5 years, mean duration of disease 15.4 +/- 1.2 years). Hypertension was present in 36.4% and diabetes mellitus in 13.0%. Impaired renal function (defined by a decrease in GFR) combined with markers of kidney damage suspective for chronic kidney disease were present in 3 patients (3.9%). Pathologic alterations of the heart were found in 25 patients (37.3%). Echocardiographic abnormalities were present in 20 patients (e.g. aortic and mitral insufficiency). Electrocardiographic abnormalities were present in 12 patients (e.g. atrioventricular, left and right branch block). Patients with cardiac abnormalities were older (54.2 +/- 2.9 vs. 44.9 +/- 1.7 years) and had a longer duration of disease (20.6 +/- 2.1 vs. 13.9 +/- 1.6 years) as compared to non-affected patients. -

CONCLUSION

In our study, cardiac abnormalities were frequently seen in patients with AS, while renal disease was more rare and might be due to diseases not related to AS in most of patients. In contrast to cardiac involvement, it therefore appears questionable, that chronic kidney disease is part of the extraskeletal manifestations, or at least that AS has a high impact on renal integrity.