Related Experiment Video
Updated: Jun 16, 2026
04:50
Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
Reversible acute renal failure complicating rheumatoid arthritis
1Fourth Department of Medicine and the Connective Tissue Research Unit, Second Department of Pathology, University of Helsinki, Finland.
Scandinavian Journal of Rheumatology
|February 11, 2010
Summary
Rheumatoid arthritis can cause reversible kidney failure due to interstitial edema. This condition, characterized by increased interstitial hyaluronic acid, leads to elevated kidney pressure and impaired function.
Area of Science:
- Nephrology
- Rheumatology
- Pathology
Background:
- Rheumatoid arthritis (RA) is known to cause kidney lesions.
- Acute renal failure in RA is poorly understood, particularly the role of interstitial nephritis.
- Previous reports lack documentation of reversible acute renal failure in RA patients.
Purpose of the Study:
- To report on two cases of reversible acute renal failure in rheumatoid arthritis patients.
- To investigate the underlying pathophysiology of acute renal failure in RA.
- To explore the role of interstitial pressure in RA-associated kidney dysfunction.
Main Methods:
- Clinical case presentation of two rheumatoid arthritis patients with acute renal failure.
- Renal biopsy analysis using light microscopy.
- Histochemical staining (toluidine blue) and enzyme sensitivity tests (hyaluronidase) to characterize interstitial components.
Main Results:
- Patients presented with reversible oliguria and impaired kidney function.
- Renal biopsies showed no glomerular, tubular, or amyloid lesions.
- Significant interstitial edema, confirmed as hyaluronidase-sensitive and metachromatic, was the primary finding.
Conclusions:
- Increased interstitial edema, likely due to abnormal hyaluronic acid concentration, may cause elevated interstitial pressure and renal insufficiency in RA.
- This mucinous kidney edema is hypothesized as an acute manifestation of systemic connective tissue pathology in RA.
- The findings suggest a novel mechanism for reversible acute renal failure in rheumatoid arthritis.
Related Concept Videos
01:23Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
01:22Acute Kidney Injury I: Introduction
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:29Acute Kidney Injury II: Pathophysiology
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
01:29Acute Kidney Injury III: Clinical Manifestations
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
01:27Dialysis
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...