Elsevier

Journal of Autoimmunity

Volume 113, September 2020, 102483
Journal of Autoimmunity

Long-term renal prognosis among patients with primary Sjögren's syndrome and renal involvement: A nationwide matched cohort study

https://doi.org/10.1016/j.jaut.2020.102483Get rights and content
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Highlights

  • This nationally representative, population-based cohort study demonstrated that 5.8% of patients with pSS had chronic kidney disease.

  • Compared to an age- and sex-matched general population cohort, patients with pSS did not have an increased risk of end-stage renal disease.

  • Regular monitoring of renal function is essential in pSS patients; however, physicians can assure patients that their renal prognosis is good.

Abstract

Background

The long-term renal outcome in patients with primary Sjögren's syndrome (pSS) remains uncertain. We aimed to determine the absolute incidence and relative risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in patients with pSS at the general population level.

Methods

We performed a retrospective cohort study using a national health insurance database in Taiwan from 2000 to 2013. We calculated the cumulative incidence of CKD and ESRD in our pSS and age-, sex- and entry time-matched control cohorts. Cox regression analyses were used to estimate adjusted hazard ratios (aHRs) after adjusting for comorbidities and medications.

Results

Among 17 505 patients with incident pSS, 1008 (5.8%) developed CKD and 38 (0.22%) developed ESRD. Of the 87 525 non-pSS controls, 3173 (3.6%) developed CKD and 256 (0.29%) developed ESRD. The risk of CKD was higher in patients with pSS than in the non-pSS controls (adjusted hazard ratio [HR] 1.49, 95% confidence interval [95% CI] 1.38–1.59). Notably, the risk of ESRD was similar in both pSS and non-pSS cohorts (aHR 0.82, 95% CI 0.58–1.16).

Conclusions

Renal prognosis among patients with pSS and renal involvement is good. Although the risk of ESRD did not increase in patients with pSS, a significantly increased risk of CKD was observed in these patients, indicating the need for increased vigilance in regular monitoring for renal complications in patients with pSS.

Keywords

Prognosis
Chronic kidney disease
End stage renal disease
Primary Sjögren's syndrome

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