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Renal tubular dysfunction in rheumatic diseases.

L D Hordon¹, H A Bird, E H Cooper

¹Clinical Pharmacology Unit, Royal Bath Hospital, Harrogate.

British Journal of Rheumatology

|April 1, 1991

Summary

Renal tubular dysfunction, indicated by abnormal urine protein levels, affects 16.5% of rheumatic disease patients. This dysfunction is linked to aging and infections, not the rheumatic disease itself.

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Area of Science:

Nephrology
Rheumatology
Clinical Medicine

Background:

Renal tubular dysfunction is a known complication in patients with rheumatic diseases.
Previous studies indicated a high prevalence in hospitalized patients with severe rheumatoid arthritis.

Purpose of the Study:

To investigate the prevalence and potential causes of renal tubular dysfunction in patients with various rheumatic diseases.
To differentiate between disease-related, drug-related, and other factors contributing to tubular dysfunction.

Main Methods:

Assessed urinary levels of alpha 1 microglobulin, beta 2 microglobulin, and microalbuminuria in 285 rheumatic disease patients.
Compared findings with a control group of 500 healthy adults.
Correlated dysfunction with age, intercurrent illnesses (e.g., urinary tract infections), rheumatic disease activity, and drug therapy.

Main Results:

Renal tubular dysfunction was detected in 16.5% of rheumatic disease patients, significantly higher than the <1% in healthy adults.
The prevalence was associated with older age and intercurrent illnesses, especially urinary tract infections.
No direct strong association was found with the specific rheumatic disease or drug therapy, though a potential additive effect on compromised kidneys was noted.

Conclusions:

Renal tubular dysfunction is prevalent in rheumatic disease patients but primarily associated with aging and infections.
Age and intercurrent infections are key risk factors for tubular dysfunction in this population.
Further research may clarify the role of drug therapy as a contributing factor in susceptible individuals.

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