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Related Experiment Videos

[Kidney involvement in rheumatoid arthritis].

A Icardi1, P Araghi, M Ciabattoni

  • 1Unità Operativa di Nefrologia e Dialisi, Dipartmento di Medicina Interna Ponente, Ospedale La Colletta, Arenzano, Genoa, Italy. andrea.icardi.usl3@libero.it

Reumatismo
|July 23, 2003
PubMed
Summary

Rheumatoid Arthritis (RA) can cause significant kidney damage, primarily through glomerulonephritis and amyloidosis. Early detection and treatment are crucial to manage RA

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Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Rheumatoid Arthritis (RA) is a systemic autoimmune disease with significant renal involvement, impacting patient prognosis and mortality.
  • The prevalence of kidney disorders in RA is debated due to varied data sources and inherent limitations.
  • Histoimmunological studies of kidney biopsies are crucial for understanding prevalent pathologies in RA-related nephropathy.

Purpose of the Study:

  • To review the spectrum of kidney diseases associated with Rheumatoid Arthritis.
  • To elucidate the prevalence and histological characteristics of renal pathologies in RA patients.
  • To discuss the nephrotoxic effects of antirheumatic drugs and their clinical significance.

Main Methods:

  • Review of histoimmunological studies on kidney biopsy specimens from RA patients with renal damage.

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  • Analysis of data from clinical findings, laboratory results, death certificates, and autopsies.
  • Compilation of information on drug-induced nephrotoxicity from long-term RA pharmacotherapy.

    • Main Results:

    • The most frequent renal pathologies in RA are glomerulonephritis (60-65%) and amyloidosis (20-30%), followed by interstitial nephritis.
    • Secondary renal amyloidosis is a major cause of end-stage renal disease in RA, strongly associated with disease activity.
    • Mesangial glomerulonephritis is the most common histological finding (35-60%) in RA nephropathies, followed by minimal change glomerulopathy and crescentic glomerulonephritis.

    Conclusions:

    • Kidney injury in RA encompasses secondary amyloidosis, drug toxicity, and rheumatoid nephropathy, significantly affecting survival.
    • Aggressive management of RA activity with immunosuppressive and combined therapies is vital to prevent amyloidosis and reduce dialysis risk.
    • Various Disease-Modifying Antirheumatic Drugs (DMARDs) and NSAIDs pose renal side effects, necessitating careful monitoring.