KIDNEY INJURY IN RHEUMATOID ARTHRITIS: RELATIONSHIP WITH CARDIOVASCULAR RISK FACTORS
https://doi.org/10.24884/1561-6274-2017-21-5-44-53
Abstract
THE AIM: retrospective and one-time evaluation of the main variants of renal pathology in rheumatoid arthritis (RA) with an assessment of cardiovascular risk and basic biomarkers of inflammation and endothelial dysfunction.
PATIENTS AND METHODS. The retrospective study included 780 patients with RA, 175 patients at one time, and 63 with nephrobiopsy. The frequency of various variants of renal damage was assessed on the background of RA, arterial hypertension, anemia. Serum concentration of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF) were determined. The comparison of the indices in the groups by the level of GFR (more than and less than 60 ml / min) was performed.
RESULTS. In patients with RA we find statistically significant differences in two groups by 10-year cardiovascular risk according to the SCORE scale was presented. Other statistically significant factors were age, the frequency of arterial hypertension, anemia, obesity, the activity of endothelial dysfunction biomarkers. Tubulointerstitial nephritis was recorded in 27 of 63 patients with nephrobiopsy performed.
CONCLUSION. Chronic kidney disease in patients with RA can be associated with cardiovascular factors – SCORE index, progressive endothelial dysfunction, age, arterial hypertension, anemia, obesity, but not with the pro-inflammatory activation.
About the Authors
S. P. Oranskiy
Kuban State Medical University
Russian Federation
Russian Federation
Associate professor, MD, PhD, Department of Internal Medicine,
350063, Krasnodar, Sedina str. 4
L. N. Yeliseyeva
Kuban State Medical University
Russian Federation
Russian Federation
Professor, MD, DMedSci., Department of Internal Medicine, chief,
350063 Krasnodar, Sedina str. 4
V. P. Kurinnaya
Kuban Regional Hospital № 1
Russian Federation
Russian Federation
MD, Unit of Nephrology, head,
350086 Krasnodar, 1 May str. 167
A. F. Davydova
Kuban Regional Hospital № 1
Russian Federation
Russian Federation
MD, Division of Rheumatology, head,
350086 Krasnodar, 1 May str. 167
References
1. Hickson LJ, Crowson CS, Gabriel SE. Development of Reduced Kidney Function in Rheumatoid Arthritis. Am J Kidney Dis 2014;63(2): 206-213
2. Демидова НВ, Гусева ИА, Каратеев ДЕ. Клинико-иммунологические аспекты раннего ревматоидного артрита. Тер арх 2010; 5:71-77 [Demidova NV, Guseva IA, Karateev DE. Kliniko-immunologicheskie aspekty rannego revmatoidnogo artrita. Ter arh 2010; 5:71-77]
3. Жигалов СА, Марасаев ВВ, Бажина ОВ. Гломерулярные поражения почек при ревматоидном артрите. Клин нефрол 2013;6:42-45 [Zhigalov SA, Marasaev VV, Bazhina OV. Glomerulyarnye porazheniya pochek pri revmatoidnom artrite. Klin nefrol 2013;6:42-45]
4. Helin HJ, Korpela MM, Mustonen JT. Renal biopsy findings and clinicopathologic correlations in rheumatoid arthritis. Arthritis Rheum 1995;38(2):242-247
5. Гасанов МЗ, Батюшин ММ, Терентьев ВП, Садовничая НА. Особенности протеомного зеркала мочи пациентов с гломерулонефропатиями различного генеза. Кубанский научный медицинский вестник 2012:4:37-42 [Gasanov MZ, Batyushin MM, Terent’ev VP, Sadovnichaya NA. Osobennosti proteomnogo zerkala mochi pacientov s glomerulonefropatiyami razlichnogo geneza. Kubanskij nauchnyj medicinskij vestnik 2012:4:37-42]
6. Jesky M, Lambert A, Burden A. The impact of chronic kidney disease and cardiovascular comorbidity on mortality in a multiethnic population: a retrospective cohort study. BMJ Open 2013;3(12). doi 10.1136/bmjopen-2013-003458
7. Toblli JE, Bevione P, Di Gennaro F. Understanding the mechanisms of proteinuria: therapeutic implications. Int J Nephrol 2012;546039. Doi 10.1155/ 2012/546039
8. Храмцова НА, Дзизинский АА. Функциональное состояние почек и сердечно-сосудистый риск при ревматоидном артрите. Кардиоваскулярная терапия и профилактика 2010;9(5):47-52 [Hramcova NA, Dzizinskij AA. Funkcional’noe sostoyanie pochek i serdechno-sosudistyj risk pri revmatoidnom artrite. Kardiovaskulyarnaya terapiya i profilaktika 2010;9(5):47-52]
9. Батюшин ММ, Выставкина ЕА. Клинические проявления и факторы риска поражения почек при ревматоидном артрите. Фундаментальные исследования 2012;2:249-252 [Batyushin MM, Vystavkina EA. Klinicheskie proyavleniya i faktory riska porazheniya pochek pri revmatoidnom artrite. Fundamental’nye issledovaniya 2012;2:249-252]
10. Karie S, Gandjbakhch F, Janus N. Kidney disease in RA patients: prevalence and implication on RA-related drugs management: the MATRIX study. Rheumatology (Oxford) 2008;47(3):350-354
11. Rasch EK, Hirsch R, Paulose-Ram R. Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: effect of different methods of case classification. Arthritis Rheum 2003;48:917–926
12. Villa-Blanco JI, Calvo-Alen J. Elderly onset rheumatoid arthritis: differential diagnosis and choice of first-line and subsequent therapy. Drugs Aging 2009;26:739-750
13. Aletaha D, Neogi T, Silman AJ. 2010 Rheumatoid Arthritis Classification Criteria. An American College of Rheumatology – European League Against Rheumatism Collaborative Initiative. Arthritis Rheum 2010;62(9): 2569-2581
14. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International, suppl. 2013;3:1-150
15. Peters MJ, Symmons DP, McCarey D. EULAR evidencebased recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 2010;69(2):325-331
16. Смирнов АВ, Петрищев НН, Панина ИЮ и др. Уровень эндотелина-1 и реактивность сосудов микроциркуляторного русла кожи у больных на ранних стадиях хронической болезни почек. Тер арх 2011 83(1):13-17 [Smirnov AV, Petrishchev NN, Panina IIu i dr. Uroven endotelina-1 i reaktivnost sosudov mikrotcirkulyatornogo rusla kozhi u bolnyh na rannih stadiyah hronicheskoy bolezni pochek. Ter arh 2011 83(1):13-17]
17. Смирнов АВ, Петрищев НН, Мнускина ММ и др. Дисфункция эндотелия и апоптоз на ранних стадиях хронической болезни почек. Терапевтический архив 2012; 84 (6): 9-15 [Smirnov AV, Petrishchev NN, Mnuskina MM i dr. Disfunktciya endoteliya i apoptoz na rannih stadiyah hronicheskoy bolezni pochek. Terapevticheskiy arhiv 2012; 84(6): 9-15]
Review
For citations:
Oranskiy S.P., Yeliseyeva L.N., Kurinnaya V.P., Davydova A.F. KIDNEY INJURY IN RHEUMATOID ARTHRITIS: RELATIONSHIP WITH CARDIOVASCULAR RISK FACTORS. Nephrology (Saint-Petersburg). 2017;21(5):42-47. (In Russ.) https://doi.org/10.24884/1561-6274-2017-21-5-44-53
Views:
13260
Email this article 