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Development of reduced kidney function in rheumatoid arthritis
LaTonya J Hickson1, Cynthia S Crowson2, Sherine E Gabriel3
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
Summary
Patients with rheumatoid arthritis (RA) have a higher risk of developing reduced kidney function compared to the general population. Cardiovascular disease and inflammation are key factors contributing to this increased risk.
Area of Science:
- Nephrology
- Rheumatology
- Epidemiology
Background:
- Rheumatoid arthritis (RA) is linked to kidney problems, but its impact on kidney function compared to the general population is not well-established.
- Understanding this association is crucial for managing RA patients' overall health and preventing complications.
Purpose of the Study:
- To investigate the incidence of reduced kidney function in patients with rheumatoid arthritis (RA) compared to individuals without RA.
- To identify factors associated with the development of reduced kidney function in RA patients.
Main Methods:
- Retrospective review of 813 adult-onset RA cases and 813 matched non-RA controls from Olmsted County, MN (1980-2007).
- Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m² and <45 mL/min/1.73m² were used to define reduced kidney function.
- Cumulative incidence was calculated, adjusting for the competing risk of death.
Main Results:
- The 20-year cumulative incidence of eGFR <60 mL/min/1.73m² was higher in RA patients (25%) versus non-RA participants (20%; P=0.03).
- Baseline cardiovascular disease (CVD) and elevated erythrocyte sedimentation rate in RA patients were associated with increased risk of eGFR <60 mL/min/1.73m².
- A greater reduction in GFR (eGFR <45 mL/min/1.73m²) was linked to an increased risk of CVD development in RA patients.
Conclusions:
- Patients with RA have a greater likelihood of developing reduced kidney function over time.
- Cardiovascular disease and inflammatory markers play a significant role in the progression of kidney dysfunction in RA.
- Increased awareness of kidney function decline in RA patients is essential for optimizing cardiovascular care and reducing morbidity.
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