Proportion of chronic kidney disease in rheumatoid arthritis patients, in a tertiary level hospital

Authors

  • Mamun Morshed Department of Medicine, Faridpur Medical College, Faridpur, Bangladesh
  • Muhammad Shahidullah Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh
  • Mridha Mohammad Shahinuzzaman Department of Medicine, Faridpur Medical College, Faridpur, Bangladesh
  • Mahadi Masud Department of Forensic Medicine, Faridpur Medical College, Faridpur, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251281

Keywords:

Chronic kidney disease, Nephrotoxicity, Rheumatoid arthritis

Abstract

Background: Chronic kidney disease (CKD) is a significant but often overlooked complication in rheumatoid arthritis (RA) patients, influenced by systemic inflammation, medication-induced nephrotoxicity, and comorbidities such as hypertension and anemia. The purpose of this study was to determine the proportion of chronic kidney disease among rheumatoid arthritis patients in a tertiary-level hospital. The aim of the study was to determine the proportion of chronic kidney disease among rheumatoid arthritis patients in a tertiary level hospital.

Methods: This cross-sectional study at the Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka (January to December 2015), included 50 RA patients (2010 ACR/EULAR criteria). Data analyzed using SPSS (t-tests, chi-square, logistic regression; p<0.05). Ethical approval obtained. Primary outcomes: CKD proportion in RA and its associations.

Results: In this study of 50 rheumatoid arthritis (RA) patients, the mean age was 47.4±14.7 years, with a female predominance (60.0%). Chronic kidney disease (CKD) was present in 22.0% of patients. Most CKD cases were in stages 3a (36.4%) and 3b (45.5%). CKD patients had a significantly longer RA duration (5.35±3.24 years vs. 2.60±1.67 years, p=0.044) and higher prevalence of hypertension (45.0% vs. 12.8%, p=0.017) and anaemia (100% vs. 61.5%, p=0.014). The majority (90.9%) of CKD patients used a combination of NSAIDs and DMARDs.

Conclusions: CKD was proportioned in 22% of RA patients, primarily in stages 3A and 3B, with longer RA duration as a key risk factor.

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References

Mitchell DM, Spitz PW, Young DY, Bloch DA, McShane DJ, Fries JF. Survival, prognosis, and causes of death in rheumatoid arthritis. Arthritis Rheum. 1986;29(6):706-14.

Wolfe F. The natural history of rheumatoid arthritis. J Rheumatol Suppl. 1996;44:13-22.

Mitchell DM, Spitz PW, Young DY, Bloch DA, McShane DJ, Fries JF. Survival, prognosis, and causes of death in rheumatoid arthritis. Arthritis Rheum. 1986;29(6):706-14. DOI: https://doi.org/10.1002/art.1780290602

Scott DL, Coulton BL, Symmons DP, Popert AJ. Long-term outcome of treating rheumatoid arthritis: results after 20 years. Lancet. 1987;329(8542):1108-11. DOI: https://doi.org/10.1016/S0140-6736(87)91672-2

Aho K, Von Essen R, Kurki P, Palosuo T, Heliövaara M. Antikeratin antibody and antiperinuclear factor as markers for subclinical rheumatoid disease process. J Rheumatol. 1993;20(8):1278-81.

Rantapää‐Dahlqvist S, De Jong BA, Berglin E, Hallmans G, Wadell G, Stenlund H, et al. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum. 2003;48(10):2741-9. DOI: https://doi.org/10.1002/art.11223

Nielen MM, van Schaardenburg D, Reesink HW, Van de Stadt RJ, van der Horst‐Bruinsma IE, de Koning MH, et al. Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors. Arthritis Rheum. 2004;50(2):380-6. DOI: https://doi.org/10.1002/art.20018

Visser K, van der Heijde D. Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature. Ann Rheum Dis. 2009;68(7):1094-9. DOI: https://doi.org/10.1136/ard.2008.092668

Bijlsma JW, Weinblatt ME. Optimal use of methotrexate: the advantages of tight control. Ann Rheum Dis. 2007;66(11):1409-10. DOI: https://doi.org/10.1136/ard.2007.076463

Hill AJ, Thomson RJ, Hunter JA, Traynor JP. The prevalence of chronic kidney disease in rheumatology outpatients. Scott Med J. 2009;54(2):9-12. DOI: https://doi.org/10.1258/rsmsmj.54.2.9

Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81(9):646-56.

Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1316-22. DOI: https://doi.org/10.1136/annrheumdis-2013-204627

Pathan E, Joshi VR. Rheumatoid arthritis and the kidney. J Assoc Physicians India. 2004;52:488-94.

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. Rheumatol. 2008;47(3):350-4. DOI: https://doi.org/10.1093/rheumatology/kem370

Hickson LJ, Crowson CS, Gabriel SE, McCarthy JT, Matteson EL. Development of reduced kidney function in rheumatoid arthritis. Am J Kidney Dis. 2014;63(2):206-13. DOI: https://doi.org/10.1053/j.ajkd.2013.08.010

Ahlmén M, Svensson B, Albertsson K, Forslind K, Hafström I, BARFOT Study Group. Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage. Ann Rheum Dis. 2010;69(1):230-3. DOI: https://doi.org/10.1136/ard.2008.102244

Jørgensen KT, Pedersen BV, Jacobsen S, Biggar RJ, Frisch M. National cohort study of reproductive risk factors for rheumatoid arthritis in Denmark: a role for hyperemesis, gestational hypertension and pre-eclampsia? Ann Rheum Dis. 2010;69(2):358-63. DOI: https://doi.org/10.1136/ard.2008.099945

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(3):517-21. DOI: https://doi.org/10.1136/ard.2008.105049

Chiu HY, Huang HL, Li CH, Chen HA, Yeh CL, Chiu SH, et al. Increased risk of chronic kidney disease in rheumatoid arthritis associated with cardiovascular complications-a national population-based cohort study. PLoS One. 2015;10(9):e0136508. DOI: https://doi.org/10.1371/journal.pone.0136508

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Published

2025-04-29

How to Cite

Morshed, M., Shahidullah, M., Shahinuzzaman, M. M., & Masud, M. (2025). Proportion of chronic kidney disease in rheumatoid arthritis patients, in a tertiary level hospital. International Journal of Research in Medical Sciences, 13(5), 1858–1862. https://doi.org/10.18203/2320-6012.ijrms20251281

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Original Research Articles