Ethnic differences in HLA antigens in Chilean donors and recipients: data from the National Renal Transplantation Program

The Ankylosing Spondylitis Performance Index: Reliability and Feasibility of an Objective Test for Physical Functioning

OBJECTIVE

Physical function in patients with axial spondyloarthritis (axSpA) is currently evaluated through questionnaires. The Ankylosing Spondylitis Performance Index (ASPI) is a performance-based measure for physical functioning, which has been validated in Dutch patients with radiographic (r-) axSpA. The interrater reliability has not yet been determined. To our knowledge, this study is the first to evaluate the validity, reliability, and feasibility of the ASPI in another patient population, including both r- and nonradiographic (nr-) axSpA patients.

METHODS

Patients with axSpA were recruited from rheumatology clinics in Santiago, Chile. Dutch instructions were translated to Spanish by a forward-backward procedure. Study visits were performed at baseline and 1-4 weeks later. Four ASPI observers were involved, measuring the performance times of the 3 ASPI tests. Validity was assessed through a patient questionnaire (numeric rating scale 0-10: ≥ 6 sufficient). For reliability, intraclass correlation coefficients (ICC) were calculated (with 95% CI). Correlations between the ASPI and disease variables were tested with regression analyses.

RESULTS

Sixty-eight patients were included (57% male, 52% r-axSpA). All patients understood the Spanish instructions and considered the ASPI to reach its aim (84%) and representativeness (85%) for physical functioning. The overall interrater (n = 62) and test-retest (n = 39) reliability (ICC) of the 3 tests combined were 0.93 (0.88-0.96) and 0.94 (0.87-0.97), respectively. Eighty-two percent of the patients completed all tests and 94% finished in < 15 min (feasibility).

CONCLUSION

This study demonstrated a high validity and feasibility in an entirely different population, with both r-axSpA and nr-axSpA. The interrater and test-retest reliability was excellent. The ASPI instructions are now available for Spanish-speaking patients.

The Association between Human Leukocyte Antigens and Hypertensive End-Stage Renal Failure among Yemeni Patients

OBJECTIVES

Many studies have attempted to locate a connection between various genetic factors and the pathogenesis of certain diseases. A number of these have found human leukocyte antigens (HLAs) to be the most significant genetic factors affecting the susceptibility of an individual to a certain disease. The present case-control study aimed to determine the connection between class I and class II HLAs and cases of hypertensive end-stage renal failure (HESRF), as contrasted with healthy controls, in Yemen.

METHODS

The study was carried out between March 2013 and March 2014 and included 50 HESRF patients attending the Urology & Nephrology Center at Al-Thawra University Hospital in Sana'a, Yemen, and 50 healthy controls visiting the same centre for kidney donation. Among both patients and controls, HLA class I (A, B and C) and class II (DRB1) genotypes were determined by polymerase chain reactions.

RESULTS

There was an association (odds ratio: 4.0) with HLA-A9(24) and HESRF, although this was not statistically significant. A significant protective function was found for the HLA-CW3 and DRB1-8 genes against the development of HESRF. Although HLA-B14 was present in some patients (0.06) and not in the controls, this difference was not statistically significant enough to conclude that HLA-B14 plays a role in the genetic predisposition for end-stage renal disease development. There was a high frequency of HLA-A2, B5, CW6, DRB1-3, DRB1-4 and DRB1-13 in both patients and controls.

CONCLUSION

Although no HLAs were found to play a highly significant role in genetic predisposition to HESRF, certain HLA genes could be considered as protective genes against HESRF development.