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Albuminuria in Rheumatoid Arthritis: Associations With Rheumatoid Arthritis Characteristics and Subclinical

Amanda Sammut1, Steven Shea1, Roger S Blumenthal2

  • 1Columbia University College of Physicians & Surgeons, New York, New York.

Arthritis Care & Research
|March 4, 2017
PubMed

Insights

Albuminuria, a marker for cardiovascular disease (CVD), is not associated with subclinical CVD in rheumatoid arthritis (RA) patients. Tumor necrosis factor inhibitors may reduce elevated urine albumin-to-creatinine ratio (uACR) in RA.

Area of Science:

  • Rheumatology
  • Cardiology
  • Nephrology

Background:

  • Albuminuria is a recognized indicator of subclinical cardiovascular disease (CVD) in the general population.
  • Rheumatoid arthritis (RA) patients exhibit increased atherosclerosis and CVD events, but the role of albuminuria in this population is unclear.

Purpose of the Study:

  • To investigate the association between elevated urine albumin-to-creatinine ratio (uACR) and subclinical CVD in patients with RA compared to non-RA controls.
  • To explore the relationship between uACR, CVD risk factors, and atherosclerosis measures in RA patients.

Main Methods:

  • Cross-sectional comparison of 196 RA patients and 271 non-RA controls.
  • Measurement of urine albumin-to-creatinine ratio (uACR) from spot morning collections.
  • Assessment of associations with CVD risk factors and atherosclerosis measures (coronary artery calcification, carotid intima-media thickness, carotid plaque).

Main Results:

  • Elevated uACR prevalence was similar between RA patients (18%) and controls (17%).
  • RA was associated with 57% lower odds of elevated uACR after adjustment (P=0.016).
  • Elevated uACR was not associated with atherosclerosis or cardiometabolic risk factors in RA patients. Treatment with tumor necrosis factor inhibitors was associated with lower uACR prevalence (9% vs. 20%, P=0.047).

Conclusions:

  • Elevated uACR is not a reliable indicator of subclinical CVD in RA patients.
  • The association between uACR and CVD risk factors differs between RA patients and controls.
  • Tumor necrosis factor inhibitor use may be linked to a reduced prevalence of elevated uACR in RA.
Abstract

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