Vigilance for kidney problems key for rheumatoid arthritis patients

April 9, 2014

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.

Explore further: Rheumatoid arthritis and heart disease: Studies shed light on dangerous connection

Related Stories

Rheumatoid arthritis and heart disease: Studies shed light on dangerous connection

October 26, 2013
People with rheumatoid arthritis and other chronic inflammatory conditions are at higher risk of heart disease. Who is in the most danger, why and how best to prevent and detect cardiovascular complications are important ...

Lower GI problems plague many with rheumatoid arthritis

April 3, 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 ...

Infections in rheumatoid arthritis patients—study finds way to pinpoint risk

September 5, 2012
Rheumatoid arthritis alone is painful and disabling, but it also puts patients at higher risk of death. The greater susceptibility to infections that accompanies the autoimmune disorder is one reason. Assessing the danger ...

Rheumatoid arthritis patients can get gout too, study finds

November 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 ...

Genetics can explain why infections trigger onset of different types of rheumatoid arthritis

March 26, 2014
(Medical Xpress)—A new international study has revealed how genetics could explain why different environmental exposures can trigger the onset of different forms of rheumatoid arthritis.

Obesity epidemic fueling rise in rheumatoid arthritis among women

April 25, 2012
Obesity and the painful autoimmune disorder rheumatoid arthritis are each becoming more common, raising a logical question: Could one have something to do with the other? For women, it appears there is a link, Mayo Clinic ...

Recommended for you

Fluid in the knee holds clues for why osteoarthritis is more common in females

June 26, 2017
Researchers have more evidence that males and females are different, this time in the fluid that helps protect the cartilage in their knee joints.

Biologics before triple therapy not cost effective for rheumatoid arthritis

May 29, 2017
Stepping up to biologic therapy when methotrexate monotherapy fails offers minimal incremental benefit over using a combination of drugs known as triple therapy, yet incurs large costs for treating rheumatoid arthritis (RA). ...

Drug for refractory psoriatic arthritis shows promise in clinical trial

May 24, 2017
In a pivotal phase-3 clinical trial led by a Stanford University School of Medicine investigator, patients with psoriatic arthritis for whom standard-of-care pharmaceutical treatments have provided no lasting relief experienced ...

Cross-species links identified for osteoarthritis

May 17, 2017
New research from the University of Liverpool, published today in the journal npj Systems Biology and Applications, has identified 'cell messages' that could help identify the early stages of osteoarthritis (OA).

Osteoarthritis could be prevented with good diet and exercise

May 12, 2017
Osteoarthritis can potentially be prevented with a good diet and regular exercise, a new expert review published in the Nature Reviews Rheumatology reports.

Rodents with trouble walking reveal potential treatment approach for most common joint disease

May 11, 2017
Maintaining the supply of a molecule that helps to nourish cartilage prevented osteoarthritis in animal models of the disease, according to a report published in Nature Communications online May 11.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.