Vigilance for kidney problems key for rheumatoid arthritis patients

Rheumatoid arthritis patients are likelier than the average person to develop chronic kidney disease, and more severe inflammation in the first year of rheumatoid arthritis, corticosteroid use, high blood pressure and obesity are among the risk factors, new Mayo Clinic research shows. Physicians should test rheumatoid arthritis patients periodically for signs of kidney problems, and patients should work to keep blood pressure under control, avoid a high-salt diet, and eliminate or scale back medications damaging to the kidneys, says senior author Eric Matteson, M.D., Mayo rheumatology chair. The study is published in the American Journal of Kidney Diseases, the National Kidney Foundation journal .

Researchers studied 813 Mayo Clinic patients with and 813 without it. They found that over a 20-year period, people with rheumatoid arthritis have a 1 in 4 chance of developing , compared with the general population's 1-in-5 risk.

"That might not seem like a lot, but in fact that's quite a big difference, and it has important implications for the course of rheumatoid arthritis and for the management of the disease," Dr. Matteson says.

In addition, heart disease is more common in rheumatoid arthritis patients who have chronic kidney disease, he adds.

Factors contributing to a higher kidney disease risk for rheumatoid arthritis patients include use of corticosteroids such as prednisone and cortisone; a higher "sed rate"—a blood test that measures inflammation—in the first year of rheumatoid arthritis; obesity; hypertension; and dyslipidemia, abnormally high cholesterol in the blood, according to the study.

There are currently no medical guidelines specifically for the management of chronic kidney disease in rheumatoid arthritis, says Dr. Matteson, adding that he hopes the research will make physicians more alert to the risk of kidney disease in rheumatoid arthritis and lead to guidelines.

Dr. Matteson recommends that physicians be careful about the medications they give people with rheumatoid arthritis, to reduce the risk of medication-induced kidney disease. Rheumatoid arthritis patients should have blood tests and urine analysis once a year or more often to detect kidney problems, depending on the medications they are taking and on other conditions such as diabetes and they may have, he says.

"Kidney disease in patients with rheumatoid arthritis can be detected very simply, and the techniques are the same as are used in the general population," Dr. Matteson says.

To reduce their risk of developing kidney disease, patients should be attentive to their and keep it under control, maintain a diet that isn't high in salt; avoid or reduce use of medications that are directly toxic to the kidneys; including nonsteroidal anti-inflammatory drugs; and get their rheumatoid arthritis and inflammation under as good of control as possible, he adds.

More research is planned to understand contributors to in rheumatoid arthritis and how to intervene to reduce the risk, Dr. Matteson says.

add to favorites email to friend print save as pdf

Related Stories

Lower GI problems plague many with rheumatoid arthritis

Apr 03, 2012

Add lower gastrointestinal (GI) problems such as ulcers, bleeding and perforations to the list of serious complications facing many rheumatoid arthritis patients. They are at greater risk for GI problems and gastrointestinal-related ...

Rheumatoid arthritis patients can get gout too, study finds

Nov 10, 2012

Refuting a belief long held by many physicians, a Mayo Clinic study found that rheumatoid arthritis patients also can get gout. The research is among several studies Mayo Clinic is presenting at the American College of Rheumatology ...

Recommended for you

Prompt diagnosis of psoriatic arthritis crucial

4 hours ago

Research led by Conway Fellow, Professor Oliver FitzGerald in St Vincent's University Hospital shows that a delay of more than 6 months from initial symptoms to a diagnosis of psoriatic arthritis leads to poorer outcomes ...

Mummy remains refute antiquity of ankylosing spondylitis

Oct 20, 2014

Ankylosing spondylitis is a systemic disease that causes inflammation in the spinal joints and was thought to have affected members of the ancient Egyptian royal families. Now a new study published in Arthritis & Rheumatology, a jour ...

Arthritis sufferers excluded from everyday life

Oct 13, 2014

Arthritis is the second leading cause of disability in Australia with many sufferers so severely disabled they cannot engage in basic everyday activities, new UNSW research has found.

User comments