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Ankylosing spondylitis: an independent risk factor for nephrolithiasis and the prognostic value of follow-up CT.

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Τίτλος: Ankylosing spondylitis: an independent risk factor for nephrolithiasis and the prognostic value of follow-up CT.
Συγγραφείς: Yue Z; Department of MRI, Henan Provincial Hospital of Traditional Chinese Medicine (the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine), Zhengzhou, China., Zhou M; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan, China.; Hubei Key Laboratory of Molecular Imaging, Wuhan, China., Hu Y; Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Wang Y; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. wangyuhui1983@163.com.; Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan, China. wangyuhui1983@163.com.; Hubei Key Laboratory of Molecular Imaging, Wuhan, China. wangyuhui1983@163.com.
Πηγή: Abdominal radiology (New York) [Abdom Radiol (NY)] 2026 Aug; Vol. 51 (8), pp. 4030-4036. Date of Electronic Publication: 2026 Jan 20.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Country of Publication: United States NLM ID: 101674571 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2366-0058 (Electronic) NLM ISO Abbreviation: Abdom Radiol (NY) Subsets: MEDLINE
Imprint Name(s): Original Publication: [New York] : Springer, [2016]-
Ιατρικοί όροι (MeSH): Tomography, X-Ray Computed*/methods , Nephrolithiasis*/diagnostic imaging , Nephrolithiasis*/etiology , Spondylitis, Ankylosing*/complications, Humans ; Female ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Aged ; Adult ; Prognosis ; Follow-Up Studies ; Aged, 80 and over
Περίληψη: Objectives: This study investigates nephrolithiasis frequency in Ankylosing spondylitis (AS) patients compared to general population. Additionally, longitudinally assessing changes in renal CT abnormalities, it seeks to provide radiological evidence for early diagnosis of nephrolithiasis in AS patients.
Methods: In this retrospective study, 115 patients fulfilling the Modified New York Criteria for AS and 115 age- and sex-matched healthy controls were included. Renal ultrasound and/or CT imaging were carried out to evaluate presence of nephrolithiasis. Participants were categorized into three groups based upon imaging outcomes: Nephrolithiasis Group, Renal Medullary Hyperattenuation (RMH) Group, and Renal-Negative Group. AS patients were further stratified by disease duration (≤ 5 years, 5-10 years, > 10 years) and age (≤ 30, 30-40, 40-50, 50-60, 60-80 years). Longitudinal follow-up of renal CT abnormalities was conducted in 15 AS patients, with changes classified as positive (progression) or negative (regression).
Results: Among AS patients, 40% (46/115) were diagnosed with nephrolithiasis, and 19.13% (22/115) exhibited RMH. In contrast, only 12.17% (14/115) of controls had nephrolithiasis, and 9.57% (11/115) showed RMH. AS patients had a significantly higher nephrolithiasis frequency (P < 0.001) and RMH (P < 0.05) compared to controls. Patients with disease duration > 10 years had a 3.01-fold higher risk of nephrolithiasis than those with a duration ≤ 5 years (P < 0.05). Male AS patients had a 3.17-fold higher risk of nephrolithiasis than females (P > 0.05). Although odds ratio (OR) for nephrolithiasis increased progressively with age in groups ≤ 60 years, no statistically significant disparities were observed among age groups. Notably, the OR for the 60 < age ≤ 80 group exceeded that of 30 < age ≤ 40 group but was lower than those of the 40 < age ≤ 50 and 50 < age ≤ 60 groups. Longitudinal follow-up revealed positive changes in renal CT abnormalities in 13 of 15 AS patients.
Conclusions: The frequency of nephrolithiasis and RMH is significantly higher in AS patients compared to general population, particularly in those with a longer disease duration. RMH might act as an early radiological indicator of nephrolithiasis in AS patients, highlighting importance of regular renal imaging for early detection and management.
(© 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Competing Interests: Declarations. Competing interests: The authors declare no competing interests.
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Li S, Du CZ, Mao SH, et al. Both structural damage and inflammation of the lumbar spine contribute to the sagittal imbalance in ankylosing spondylitis patients with thoracolumbar kyphosis. Quant Imaging Med Surg. 2021;11(1):362–70. (PMID: 10.21037/qims-19-990333920357719924)
Dean LE, Jones GT, MacDonald AG, et al. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford). 2014;53(4):650–7. (PMID: 10.1093/rheumatology/ket38724324212)
Kilic G, Kilic E, Ozgocmen S. Is there any gender-specific difference in the cut‐off values of ankylosing spondylitis disease activity score in patients with axial spondyloarthritis? International Journal of Rheumatic Diseases. 2017;20(9):1201–11. (PMID: 10.1111/1756-185X.1288527309497)
Taurog JD, Longo DL, Chhabra A, et al. Ankylosing Spondylitis and Axial Spondyloarthritis. New England Journal of Medicine. 2016;374(26):2563–74. (PMID: 10.1056/NEJMra140618227355535)
El Maghraoui A. Extra-articular manifestations of ankylosing spondylitis: Prevalence, characteristics and therapeutic implications. Eur J Intern Med. 2011;22(6):554–60. (PMID: 10.1016/j.ejim.2011.06.00622075279)
Jakobsen AK, Jacobsson LT, Patschan O, et al. Is Nephrolithiasis an Unrecognized Extra-Articular Manifestation in Ankylosing Spondylitis? A Prospective Population-Based Swedish National Cohort Study with Matched General Population Comparator Subjects. PLoS One. 2014;9(11):e113602. (PMID: 10.1371/journal.pone.0113602254234714244108)
Henares O, Pflimlin A, Romand X, et al. Urolithiasis in ankylosing spondylitis: A meta-analysis. Joint Bone Spine. 2022;89(5):105388. (PMID: 10.1016/j.jbspin.2022.10538835490944)
Korkmaz C, Cansu DÜ, Sayer JA. Urolithiasis as an extraarticular manifestation of ankylosing spondylitis. Rheumatology International. 2017;37(12):1949–56. (PMID: 10.1007/s00296-017-3788-028822009)
Canales BK, Leonard SM, Singh JA, et al. Spondyloarthropathy: an independent risk factor for kidney stones. J Endourol. 2006;20(8):542–6. (PMID: 10.1089/end.2006.20.54216903811)
Yan F, Liu J, Tao J, et al. Causality between ankylosing spondylitis and urolithiasis in European Populations: A Mendelian randomization analysis. Fr J Urol. 2024;34(13):102750. (PMID: 10.1016/j.fjurol.2024.10275039305997)
Jakobsen AK, Jacobsson LTH, Patschan O, et al. Surgical interventions for nephrolithiasis in ankylosing spondylitis and the general population. Scand J Urol. 2015;49(6):486–91. (PMID: 10.3109/21681805.2015.108952326389795)
Incel NA, Gokoglu F, Nacir B, et al. Bone and stone in ankylosing spondylitis: osteoporosis and urolithiasis. Clin Rheumatol. 2006;25(5):667–70. (PMID: 10.1007/s10067-005-0114-016333564)
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Contributed Indexing: Keywords: Ankylosing spondylitis (AS); Computed tomography (CT) follow-up; Nephrolithiasis; Renal medullary hyperattenuation (RMH)
Entry Date(s): Date Created: 20260120 Date Completed: 20260721 Latest Revision: 20260803
Update Code: 20260803
DOI: 10.1007/s00261-026-05387-3
PMID: 41557183
Βάση Δεδομένων: MEDLINE
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  Data: Ankylosing spondylitis: an independent risk factor for nephrolithiasis and the prognostic value of follow-up CT.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yue+Z%22&quot;&gt;Yue Z&lt;/searchLink&gt;; Department of MRI, Henan Provincial Hospital of Traditional Chinese Medicine (the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine), Zhengzhou, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhou+M%22&quot;&gt;Zhou M&lt;/searchLink&gt;; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.; Hubei Provincial Clinical Research Center for Precision Radiology &amp; Interventional Medicine, Wuhan, China.; Hubei Key Laboratory of Molecular Imaging, Wuhan, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Hu+Y%22&quot;&gt;Hu Y&lt;/searchLink&gt;; Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+Y%22&quot;&gt;Wang Y&lt;/searchLink&gt;; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. wangyuhui1983@163.com.; Hubei Provincial Clinical Research Center for Precision Radiology &amp; Interventional Medicine, Wuhan, China. wangyuhui1983@163.com.; Hubei Key Laboratory of Molecular Imaging, Wuhan, China. wangyuhui1983@163.com.
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  Data: Objectives: This study investigates nephrolithiasis frequency in Ankylosing spondylitis (AS) patients compared to general population. Additionally, longitudinally assessing changes in renal CT abnormalities, it seeks to provide radiological evidence for early diagnosis of nephrolithiasis in AS patients.&lt;br /&gt;Methods: In this retrospective study, 115 patients fulfilling the Modified New York Criteria for AS and 115 age- and sex-matched healthy controls were included. Renal ultrasound and/or CT imaging were carried out to evaluate presence of nephrolithiasis. Participants were categorized into three groups based upon imaging outcomes: Nephrolithiasis Group, Renal Medullary Hyperattenuation (RMH) Group, and Renal-Negative Group. AS patients were further stratified by disease duration (≤ 5 years, 5-10 years, &amp;gt; 10 years) and age (≤ 30, 30-40, 40-50, 50-60, 60-80 years). Longitudinal follow-up of renal CT abnormalities was conducted in 15 AS patients, with changes classified as positive (progression) or negative (regression).&lt;br /&gt;Results: Among AS patients, 40% (46/115) were diagnosed with nephrolithiasis, and 19.13% (22/115) exhibited RMH. In contrast, only 12.17% (14/115) of controls had nephrolithiasis, and 9.57% (11/115) showed RMH. AS patients had a significantly higher nephrolithiasis frequency (P &amp;lt; 0.001) and RMH (P &amp;lt; 0.05) compared to controls. Patients with disease duration &amp;gt; 10 years had a 3.01-fold higher risk of nephrolithiasis than those with a duration ≤ 5 years (P &amp;lt; 0.05). Male AS patients had a 3.17-fold higher risk of nephrolithiasis than females (P &amp;gt; 0.05). Although odds ratio (OR) for nephrolithiasis increased progressively with age in groups ≤ 60 years, no statistically significant disparities were observed among age groups. Notably, the OR for the 60 &amp;lt; age ≤ 80 group exceeded that of 30 &amp;lt; age ≤ 40 group but was lower than those of the 40 &amp;lt; age ≤ 50 and 50 &amp;lt; age ≤ 60 groups. Longitudinal follow-up revealed positive changes in renal CT abnormalities in 13 of 15 AS patients.&lt;br /&gt;Conclusions: The frequency of nephrolithiasis and RMH is significantly higher in AS patients compared to general population, particularly in those with a longer disease duration. RMH might act as an early radiological indicator of nephrolithiasis in AS patients, highlighting importance of regular renal imaging for early detection and management.&lt;br /&gt; (&#169; 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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  Data: Declarations. Competing interests: The authors declare no competing interests.
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  Data: Navarro-Compan V, Sepriano A, Capelusnik D, et al. Axial spondyloarthritis. Lancet. 2025;405(10473):159–72. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1016%2FS0140-6736%2824%2902263-339798984%22&quot;&gt;10.1016/S0140-6736(24)02263-339798984)&lt;/searchLink&gt;&lt;br /&gt;Li S, Du CZ, Mao SH, et al. Both structural damage and inflammation of the lumbar spine contribute to the sagittal imbalance in ankylosing spondylitis patients with thoracolumbar kyphosis. Quant Imaging Med Surg. 2021;11(1):362–70. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E21037%2Fqims-19-990333920357719924%22&quot;&gt;10.21037/qims-19-990333920357719924)&lt;/searchLink&gt;&lt;br /&gt;Dean LE, Jones GT, MacDonald AG, et al. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford). 2014;53(4):650–7. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1093%2Frheumatology%2Fket38724324212%22&quot;&gt;10.1093/rheumatology/ket38724324212)&lt;/searchLink&gt;&lt;br /&gt;Kilic G, Kilic E, Ozgocmen S. Is there any gender-specific difference in the cut‐off values of ankylosing spondylitis disease activity score in patients with axial spondyloarthritis? International Journal of Rheumatic Diseases. 2017;20(9):1201–11. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1111%2F1756-185X%2E1288527309497%22&quot;&gt;10.1111/1756-185X.1288527309497)&lt;/searchLink&gt;&lt;br /&gt;Taurog JD, Longo DL, Chhabra A, et al. Ankylosing Spondylitis and Axial Spondyloarthritis. New England Journal of Medicine. 2016;374(26):2563–74. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1056%2FNEJMra140618227355535%22&quot;&gt;10.1056/NEJMra140618227355535)&lt;/searchLink&gt;&lt;br /&gt;El Maghraoui A. 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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Ankylosing spondylitis (AS); Computed tomography (CT) follow-up; Nephrolithiasis; Renal medullary hyperattenuation (RMH)
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        Text: English
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      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
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      – SubjectFull: Tomography, X-Ray Computed methods
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      – SubjectFull: Nephrolithiasis diagnostic imaging
        Type: general
      – SubjectFull: Nephrolithiasis etiology
        Type: general
      – SubjectFull: Spondylitis, Ankylosing complications
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      – TitleFull: Ankylosing spondylitis: an independent risk factor for nephrolithiasis and the prognostic value of follow-up CT.
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            – D: 01
              M: 08
              Text: 2026 Aug
              Type: published
              Y: 2026
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            – TitleFull: Abdominal radiology (New York)
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