Chronic Kidney Disease in Patients with Psoriatic Arthritis: A Cohort Study

Fadi Kharouf¹, Shangyi Gao², Shahad Al-Matar³, Daniel Pereira⁴, Richard Cook⁵, Vinod Chandran⁶ and Dafna Gladman⁷, ¹University Health Network and University of Toronto, Toronto, ON, Canada, Toronto, ON, Canada, ²Toronto Western Hospital, University of Toronto, Toronto, ON, Canada, ³Toronto Western Hospital, University of Toronto, Toronto, Canada, ⁴University Health Network, Toronto, ON, Canada, ⁵University of Waterloo, Waterloo, Canada, ⁶University of Toronto, Toronto, ON, Canada, ⁷University of Toronto, Toronto Western Hospital, Toronto, ON, Canada

Meeting: ACR Convergence 2024

Keywords: Disease-Modifying Antirheumatic Drugs (Dmards), Nonsteroidal antiinflammatory drugs (NSAIDs), Psoriatic arthritis, Renal

Session Information

Date: Monday, November 18, 2024

Title: SpA Including PsA – Diagnosis, Manifestations, & Outcomes Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Chronic kidney disease (CKD) is a comorbidity in psoriatic arthritis (PsA). In this study, we aimed to define the prevalence of CKD in patients with PsA, describe their long-term renal outcomes, and identify risk factors for CKD development.

Methods: We included patients with PsA followed at our prospective observational cohort. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m² for at least 3 months. We characterized long-term renal outcomes of CKD cases identified following clinic entry. We used time-dependent Cox regression models to identify factors associated with CKD development.

Results: 1336 patients were included in the study, with a mean (standard deviation) age of 44.9 (13.1) years; 746 (55.8%) were males (Table 1). The mean creatinine level at clinic entry was 78.7 (35.4) μmol/L and the mean eGFR level was 98 (19.9) mL/min/1.73m².

123 (9.2%) patients were observed to have CKD. Of these, 25 (20.3%) had CKD at clinic entry and 98 (79.7%) developed CKD during follow-up at a median [interquartile range] of 8.2 [2.8, 14.0] years from baseline. Doubling of baseline creatinine was observed in 18 of 98 (18.3%) new CKD patients. 49 (50%) patients developed a sustained ≥40% reduction in baseline eGFR. Two patients developed eGFR< 15 mL/min/1.73m². In the multivariate Cox regression model adjusted for age at study entry, sex, and baseline eGFR (Table 2), factors independently associated with the development of CKD included diabetes mellitus (HR 2.58, p< 0.001), kidney stones (HR 2.14, p=0.01), radiographic damaged joint count (HR 1.02, p=0.02), uric acid level (HR 1.21, p< 0.001; 50-unit increase), daily use of NSAIDs (HR 1.77, p=0.02), and methotrexate use (HR 0.51, p= 0.01).

Conclusion: CKD is not infrequent in patients with PsA. Its development is associated with related comorbidities, joint damage, and NSAID use. Methotrexate use may be protective.

Disclosures: F. Kharouf: None; S. Gao: None; S. Al-Matar: None; D. Pereira: None; R. Cook: None; V. Chandran: AbbVie/Abbott, 1, 5, AstraZeneca, 12, Spousal employment, Bristol-Myers Squibb(BMS), 1, Eli Lilly, 1, Janssen, 1, Novartis, 1, UCB, 1; D. Gladman: AbbVie, 2, 5, Amgen, 2, 5, AstraZeneca, 2, BMS, 2, Celgene, 2, 5, Eli Lilly, 2, 5, Galapagos, 2, 5, Gilead, 2, 5, Janssen, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, UCB, 2, 5.

To cite this abstract in AMA style:

Kharouf F, Gao S, Al-Matar S, Pereira D, Cook R, Chandran V, Gladman D. Chronic Kidney Disease in Patients with Psoriatic Arthritis: A Cohort Study [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/chronic-kidney-disease-in-patients-with-psoriatic-arthritis-a-cohort-study/. Accessed .

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