J Rheum Dis.  2011 Sep;18(3):181-186. 10.4078/jrd.2011.18.3.181.

The Prevalence and Associated Factors of Kidney Disease in Korean Rheumatoid Arthritis Patients

Affiliations
  • 1Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea. ywhim@jbnu.ac.kr

Abstract


OBJECTIVE
To determine the prevalence and associated factors of kidney disease in Korean rheumatoid arthritis (RA) patient, and describe the profile of RA drugs prescribed in RA patients.
METHODS
A total of 284 patients at the division of rheumatology with confirmed RA were prospectively included in this study from May 1 to August 31, 2008. Renal function was assessed using Cockcroft-Gault (CG) and abbreviated Modification of Diet in Renal Disease (aMDRD) study formulae, and classified by the National Kidney Foundation (NKF) classification. Comparisons was were performed by the two sample t-test, chi-square-test and binary logistic regression analysis.
RESULTS
Of 281 patients with RA, only 7 (2.5%) patients had abnormal serum creatinine (sCr) levels. According to the NFK classification, the prevalence of kidney disease using aMDRD and CG formula was 23.8% and 31.7%, respectively. Among the patients with eGRF <60 mL/min/m2 according to aMDRD or CG formulae, 91.8~100% received at least one drug that was potentially nephrotoxic. RA patients with renal dysfunction was associated with advanced age, body mass index (BMI), antinuclear antibody (ANA).
CONCLUSION
Estimation of renal function with CG or aMDRD formulae is important in RA patients, particularly in those with low BMI or old age. Also, appropriate dosage adjustment is needed in patients with renal dysfunction.

Keyword

Rheumatoid arthritis; Kidney disease

MeSH Terms

Antibodies, Antinuclear
Arthritis, Rheumatoid
Body Mass Index
Creatinine
Diet
Humans
Kidney
Kidney Diseases
Logistic Models
Prevalence
Prospective Studies
Rheumatology
Antibodies, Antinuclear
Creatinine

Reference

References

1. Karstila K, Korpela M, Sihvonen S, Mustonen J. Prognosis of clinical renal disease and incidence of new renal findings in patients with rheumatoid arthritis: followup of a population-based study. Clin Rheumatol. 2007; 26:2089–95.
Article
2. Helin HJ, Korpela MM, Mustonen JT, Pasternack AI. Renal biopsy findings and clinicopathologic correlations in rheumatoid arthritis. Arthritis Rheum. 1995; 38:242–7.
Article
3. Nakano M, Ueno M, Nishi S, Shimada H, Hasegawa H, Watanabe T, et al. Analysis of renal pathology and drug history in 158 Japanese patients with rheumatoid arthritis. Clin Nephrol. 1998; 50:154–60.
4. Karie S, Gandjbakhch F, Janus N, Launay-Vacher V, Rozenberg S, Mai Ba CU, et al. Kidney disease in RA patients: prevalence and implication on RA-related drugs management: the MATRIX study. Rheumatology (Ox-ford). 2008; 47:350–4.
Article
5. Koseki Y, Goto M. Secondary amyloidosis associated with rheumatoid arthritis (RA). Nihon Rinsho. 2005; 63(Suppl 1):278–82.
6. Koivuniemi R, Paimela L, Suomalainen R, Leirisalo-Repo M. Amyloidosis as a cause of death in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2008; 26:408–13.
7. Thomas E, Symmons DP, Brewster DH, Black RJ, Macfarlane GJ. National study of cause-specific mortality in rheumatoid arthritis, juvenile chronic arthritis, and other rheumatic conditions: a 20 year followup study. J Rheumatol. 2003; 30:958–65.
8. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16:31–41.
Article
9. Levey AS, Coresh J, Greene T, Marsh J, Stevens LA, Kusek JW, et al. Chronic Kidney Disease Epidemiology Collaboration. Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem. 2007; 53:766–72.
10. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39(2 Suppl 1):S1–266.
11. Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2003; 41:1–12.
Article
12. van Acker BA, Koomen GC, Koopman MG, de Waart DR, Arisz L. Creatinine clearance during cimetidine administration for measurement of glomerular filtration rate. Lancet. 1992; 340:1326–9.
Article
13. Petri M, Bockenstedt L, Colman J, Whiting-O'Keefe Q, Fitz G, Sebastian A, et al. Serial assessment of glomerular filtration rate in lupus nephropathy. Kidney Int. 1988; 34:832–9.
Article
14. Chagnac A, Kiberd BA, Fariñas MC, Strober S, Sibley RK, Hoppe R, et al. Outcome of the acute glomerular injury in proliferative lupus nephritis. J Clin Invest. 1989; 84:922–30.
Article
15. Anders HJ, Rihl M, Vielhauer V, Schattenkirchner M. Assessment of renal function in rheumatoid arthritis: val-idity of a new prediction method. J Clin Rheumatol. 2002; 8:130–3.
16. Karstila K, Harmoinen AP, Lehtimäki TJ, Korpela MM, Mustonen JT, Saha HH. Measurement of the kidney function in patients with rheumatoid arthritis: plasma cystatin C versus 51Cr-EDTA clearance. Nephron Clin Pract. 2008; 108:c284–90.
17. Aronoff GR, Berns JS, Brier ME, Golper Ta, Morrison G, Singer I, et al. Drug prescribing in renal failure:dosing guidelines for adults. Philadelphia: American College of Physicians-American society of internal medicine;1999.
18. Daoussis D, Panoulas VF, Antonopoulos I, John H, Toms TE, Wong P, et al. Cardiovascular risk factors and not disease activity, severity or therapy associate with renal dysfunction in patients with rheumatoid arthritis. Ann Rheum Dis. 2010; 69:517–21.
19. Boey O, Van Hooland S, Woestenburg A, Van der Niepen P, Verbeelen D. Methotrexate should not be used for patients with end-stage kidney disease. Acta Clin Belg. 2006; 61:166–9.
Article
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