Introduction
Ankylosing spondylitis (AS) is a chronic inflammatory illness that mostly affects the spine and sacroiliac joints and can also have systemic effects, including possible kidney involvement. Even though kidney problems are less frequent than other ankylosing spondylitis symptoms, if not addressed, they can have serious health consequences. Ankylosing spondylitis is a chronic inflammatory condition that progresses over time; the body might experience inflammation in many different areas.
Everybody experiences symptoms and complications differently. The majority of persons with ankylosing spondylitis will not experience renal issues. It may not be as uncommon as previously believed. According to research, 8 percent to 35 percent of individuals with ankylosing spondylitis have kidney dysfunction. There are several other reasons why kidney difficulties might occur in addition to this illness.
What Kidney Problems Are Associated With Ankylosing Spondylitis?
Ankylosing spondylitis may have systemic consequences that could exacerbate renal issues. Even though renal involvement in ankylosing spondylitis is less prevalent than other disease symptoms, if left untreated, it can have serious health consequences.
Common issues with the kidney linked to Ankylosing spondylitis
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Secondary Amyloidosis: The illness known as amyloidosis is typified by an aberrant accumulation of proteins in the kidneys and other organs. This protein accumulation in ankylosing spondylitis patients may result in renal inflammation, scarring, and decreased kidney function.
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Immunoglobulin A Nephropathy (IgAN): Berger's disease, sometimes called immunoglobulin A nephropathy (IgAN), is another possible renal problem linked to Ankylosing spondylitis. Immunoglobulin A (IgA) antibodies accumulate in the kidneys, causing inflammation and, in certain situations, renal injury.
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Chronic Kidney Disease: The kidneys maintain the proper ratio of salts and minerals in the blood by filtering waste materials. Because the injured kidneys cannot keep up, waste products accumulate in the body in CKD. This may result in other health issues, such as heart disease, which increases the risk of heart attack and stroke. Progressive chronic kidney disease (CKD) can eventually result in renal failure.
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Kidney Stones: Studies also indicate kidney stones are more common in Ankylosing spondylitis patients than in healthy individuals, particularly those with long-standing Ankylosing spondylitis. Hard deposits of minerals and salts accumulating in the kidneys are kidney stones. Kidney stones can frequently be passed by urinating, although they can be extremely painful. Infections or stones becoming trapped in the urinary tract are also possible.
What Are the Reasons for Kidney Problems in Ankylosing Spondylitis?
It might be challenging to identify the precise causes of renal illness. Researchers have discovered more than thirty proteins that produce amyloid. Ankylosing spondylitis is a chronic inflammatory illness that can cause this kind of protein accumulation. A substantial correlation exists between CKD and hyperuricemia, or increased uric acid, in individuals with Ankylosing spondylitis.
Several inflammatory arthritis medicines may also impact kidney function.
These consist of:
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NSAIDs, or nonsteroidal anti-inflammatory drugs.
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High-dose medications that alter disease.
Other diseases, including diabetes and high blood pressure, can also impact the kidneys. Thus, there might be a number of influencing variables.
What Are the Symptoms of Kidney Problems Associated With Ankylosing Spondylitis?
Signs of ankylosing spondylitis, kidney involvement in ankylosing spondylitis, and kidney dysfunction may not always be accompanied by apparent symptoms.
But there are a few possible symptoms and indicators to be aware of:
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Decreased Urine Production: Kidney impairment may be indicated by oliguria, a marked decrease in urine production.
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Legs or Ankles Swelling: Lower extremity swelling or edema may indicate fluid retention, which can stress the kidneys.
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Blood in the Urine: Hematuria, or blood in the urine, is a sign of renal inflammation or injury.
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Weakness and Fatigue: Anemia, which can result from kidney disease, can be indicated by weakness and weariness.
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High Blood Pressure: Also known as hypertension, high blood pressure can exacerbate renal damage and put an additional load on the kidneys.
How to Diagnose Kidney Problems Associated With Ankylosing Spondylitis?
Ankylosing spondylitis with kidney issues must be diagnosed using a multimodal approach, including imaging scans, laboratory testing, and clinical evaluation.
Clinical Assessment
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Comprehensive Medical History: A comprehensive medical history should be obtained, covering the beginning and development of ankylosing spondylitis symptoms, any family history of renal issues, and an assessment of the drugs and supplements currently being taken.
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Physical Examination: The goal of a physical examination should be to look for indications of Ankylosing spondylitis, such as pain, stiffness, and reduced spinal motion, in the musculoskeletal system, especially in the spine.
Lab Examinations
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Complete Blood Count (CBC): This test can identify anemia, which may result from renal failure.
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The Basic Metabolic Panel: The Basic Metabolic Panel (BMP) measures blood urea nitrogen (BUN), creatinine, and electrolyte values to evaluate kidney function. Increased concentrations of these drugs may be a sign of renal damage.
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Urine Analysis: A urinalysis looks for blood, protein, and white blood cells in the urine, as these elements may indicate kidney inflammation or injury.
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Immunoglobulin A (IgA) Level: An increased risk of immunoglobulin A nephropathy (IgAN), a kidney condition linked to ankylosing spondylitis, may be connected to a higher IgA level in the blood.
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Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP): These inflammatory markers can be high in ankylosing spondylitis and may signal kidney problems.
Imaging Research
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MRIs and X-Rays: By highlighting distinctive alterations in the bones and joints, MRIs and X-rays of the spine and sacroiliac joints can aid in diagnosing ankylosing spondylitis.
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Kidney Ultrasound: Through visual inspection, an ultrasound may evaluate the kidneys' dimensions, composition, and blood flow. Additionally, it can identify anomalies that might point to renal illness.
What Are the Treatment Options for Kidney Problems Associated With Ankylosing Spondylitis?
A multifaceted strategy is necessary to treat ankylosing spondylitis with renal difficulties, addressing the specific kidney complications and the underlying inflammation of ankylosing spondylitis.
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Disease-Modifying Antirheumatic Medications (DMARDs): DMARDs, which include sulfasalazine and methotrexate, can lessen joint damage and delay the advancement of ankylosing spondylitis.
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Inhibitors of the Tumor Necrosis Factor (TNF): These biological drugs, which target particular inflammatory pathways, can be beneficial in treating severe ankylosing spondylitis. Examples of these drugs include adalimumab, etanercept, and infliximab.
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Blood Pressure Regulation: Preserving renal function requires maintaining normal blood pressure. Blood pressure can be regulated by lifestyle adjustments like eating differently, controlling weight, and exercising regularly. Medication for high blood pressure may be required in some situations.
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Dietary Changes: A low-protein diet may be advised to lessen the strain on the kidneys. Reducing salt consumption can also assist in lowering fluid retention and controlling blood pressure.
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Drugs for Particular Kidney Problems: Certain drugs for amyloidosis may work by concentrating on the aberrant protein accumulation. Medication for IgAN may be used to lower inflammation and stop more kidney damage.
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Dialysis or Kidney Transplantation: To restore kidney function in advanced renal disease situations, dialysis or kidney transplantation may be required.
Conclusion
An individualized and thorough treatment plan that considers the particular kidney troubles and the underlying inflammatory disease is necessary for treating ankylosing spondylitis patients with kidney issues. Early diagnosis, timely action, and continuous monitoring are essential for the illness to be adequately managed and kidney function preserved.
