Renal function and cardiovascular risk in rheumatoid arthritis

Renal function and cardiovascular risk in rheumatoid arthritis

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Aim.To study renal function and its association with cardiovascular risk factors in rheumatoid arthritis (RA).Material and methods.The study included 257 RA patients aged 29—69 years.

Results.Reduced glomerular filtration rate (GFR) <60 ml/min was observed in 146 (56,8 %) RA patients.Renal dysfunction was associated with non-steroid anti-inflammatory drug read more (NSAID) therapy (OR 24,5; p<0,01), microalbuminuria (OR 17,8; p<0,01), high RA activity by DAS 28 (OR 6,1; p<0,01), pulse blood pressure (PBP) >55 mm Hg (OR 4,38; p<0,01), arterial hypertension (AH) (OR 3,15; p<0,01), atherogenic dyslipidemia (DLP) (OR 2,83; p<0,01), RA duration >10 years (OR 2,8; p<0,01), hyperglycaemia (OR 2,35; p<0,05), age >50 years (OR 2,17; p<0,01) and “non-dipper” BP profile (OR 1,85; p<0,05).GFR negatively correlated with vascular stiffness index (r=-0,23; p<0,01), LV myocardial mass index (r=-0,2; p<0,05), C-reactive protein level (r=-0,31; p<0,01), RA activity by DAS 28 (r=-0,29; p<0,01), age (r=-0,33; p<0,01), RA duration korpskaft (r=-0,29; p<0,01), intima-media thickness (IMT) (r=-0,28; p<0,01), mean circadian systolic BP level (r=-0,19; p<0,05) and PBP level (r=-0,31; p<0,01), as well as SCORE-assessed cardiovascular risk level (r=-0,17; p<0,05).

Conclusion.In RA, GFR reduction is a complication of chronic inflammation and long-term NSAID therapy.It is associated with AH, atherogenic DLP, and high cardiovascular risk.