Subclinical renal dysfunction is independently associated with cardiovascular events in rheumatoid arthritis: the
A M van Sijl1, I A M van den Oever, M J L Peters
1Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, The Netherlands.
Insights
Patients with rheumatoid arthritis (RA) face higher cardiovascular disease (CVD) risks. Impaired kidney function, indicated by lower estimated glomerular filtration rate (eGFR), independently predicts CVD events in RA patients.
Area of Science:
- Rheumatology
- Nephrology
- Cardiology
Background:
- Rheumatoid arthritis (RA) patients exhibit a doubled risk of cardiovascular (CV) disease, often independent of conventional risk factors.
- Renal dysfunction is a known predictor of CV morbidity and mortality in the general population, but its role in RA remains under-researched.
Purpose of the Study:
- To investigate the relationship between renal function and the incidence of CV events in patients with rheumatoid arthritis.
Main Methods:
- The study utilized data from the ongoing CARRÉ Study, a prospective cohort of Dutch RA patients.
- Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease formula.
- Logistic regression analysis was employed to assess the association between eGFR and CV event occurrence.
Main Results:
- Over a 3-year follow-up of 353 RA patients, 23 (7%) experienced a CV event.
- Patients with a CV event had significantly lower baseline eGFR (59 ml/min) compared to those without (79 ml/min).
- A decrease in eGFR of 5 ml/min correlated with a 30% increased risk of CV events, even after adjusting for traditional risk factors.
Conclusions:
- Renal dysfunction is confirmed as an independent risk factor for cardiovascular disease in rheumatoid arthritis patients.
- These findings highlight the importance of monitoring renal function in RA management to mitigate cardiovascular risk.
Background:
Patients with rheumatoid arthritis (RA) have double the risk of cardiovascular (CV) disease, largely independently of traditional CV risk factors. Renal dysfunction is associated with CV morbidity and mortality in the general population, but data on this association in RA are lacking.
Objective:
To investigate the association between renal function and CV events in RA.
Methods:
The CARRÉ Study is an ongoing prospective cohort study of Dutch patients with RA, which records CV events. Glomerular filtration rate (GFR) was estimated with the abbreviated Modification of Diet in Renal Disease formula. Logistic regression determined the association between estimated GFR and the occurrence of CV events.
Results:
353 patients were followed for 3 years, and 23 (7%) had a CV event. Patients who had an event had a significantly lower baseline GFR than those who did not (59 vs 79 ml/min, p=0.001). This association remained significant after adjustment for traditional risk factors: in this analysis, a decrease in GFR of 5 ml/min was associated with a 30% (95% CI 7% to 59%) increase in the occurrence of CV events. During follow-up, an unfavourable change in GFR was noted in patients who later had a CV event compared with those who did not.
Conclusion:
These data confirm that, in RA, renal dysfunction is associated with a higher risk of CV disease independently of traditional CV risk factors.
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