J Rheum Dis.  2017 Aug;24(4):174-184. 10.4078/jrd.2017.24.4.174.

Renal Involvement in Rheumatic Diseases

• Ahn SH
• Jung JH

• KMID: 2389058
• DOI: http://doi.org/10.4078/jrd.2017.24.4.174

Abstract

Most rheumatic diseases are chronic inflammatory diseases. Kidney-related symptoms of rheumatic diseases are often present, which increase mortality and morbidity of patients with rheumatic diseases. When patients with rheumatic diseases show signs or symptoms of renal involvement, management for primary rheumatic diseases should be more aggressive. In general, the risk and severity of renal involvement in patients with rheumatic diseases depend on the type of primary rheumatic diseases. Rheumatic disease itself, chronic use of immunosuppressive agents and non-steroidal anti-inflammatory drugs, and comorbidities, such as diabetes, hypertension, and cardiovascular complications, are the main causes of renal involvement in patients with rheumatic diseases. Many studies have reported the predominant features of renal involvement in most rheumatic diseases. We have attempted to summarize the relationships between rheumatic diseases and renal diseases, and clinical or pathophysiological features of renal involvement resulting from primary rheumatic diseases except systemic lupus erythematosus. Review for renal involvement, particularly in relation to early diagnosis and management of renal involvement in rheumatic diseases, is clinically significant because renal involvement in rheumatic diseases generally implies a bad prognosis.

Keyword

Kidney diseases; Rheumatic diseases; Inflammation

MeSH Terms

Comorbidity
Early Diagnosis
Humans
Hypertension
Immunosuppressive Agents
Inflammation
Kidney Diseases
Lupus Erythematosus, Systemic
Mortality
Prognosis
Rheumatic Diseases*
Immunosuppressive Agents

Figure

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  Figure 1. Treatment of ANCA-associated renal vasculitis. IV methylprednisolone usually begins with 7 mg/kg per day of methylprednisolone for 3 days and followed by oral prednisone 1 mg/kg per day. IV cyclophosphamide usually begins with 0.5 g/m2 per monthly of cyclophosphamide. Oral cyclophosphamide usually begins with 2 mg/kg per day of cyclophosphamide and the dose can be reduced based on renal function or age. Oral prednisone should be tapered slowly during 3 to 6 months. Oral azathioprine usually begin with 2 mg/kg per day of azathioprine. ANCA: anti-neutrophilic cytoplasmic antibody, IV: intravenous, PE: plasma exchange.

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