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Abstract: TH-PO1023

Prevalence of Renal Dysfunction Among Rheumatoid Arthritis Patients in Jordan

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Oweis, Ashraf Omar, Jordan University Of Science and Technology, Amman, Jordan
  • Alshelleh, Sameeha A., University of Jordan, Amman, Jordan
Background

Rheumatoid Arthritis (RA) is an autoimmune disorder characterized by inflammation of multiple synovial joints, it
can affect other organs such as kidneys.
RA can affect the kidneys by direct effect of the disease itself, or secondary to the drugs used to treat the disease; both biological agents as well as simple analgesics like non-steroidal anti-inflammatory drugs(NSAIDs).
Clinico-pathological correlations showed that the most common pathological findings on renal biopsy were secondary amyloidosis, membranous nephropathy, less commonly RA can cause rapidly progressive glomerulonephritis

Methods

Using our electronic records, we retrospectively evaluated RA patients in our tertiary referral hospital between 2010 – 2016 with at least one year follow up, renal dysfunction was defined as the presence of hematuria and/or at least +1 proteinuria on dipstick urine analysis on at least 2 occasions, and/or abnormal serum creatinine values.
Glomerular filtration rate was calculated using CKD-EPI equation

Results

We evaluated 233 patients with a diagnosis of RA, mean age was 54.5 years, females were 84.9% vs. 15.1% for males, for baseline characteristics see Table 1.
44 patients (18.8%) presented with microscopic hematuria, 16 (6.9%) with proteinuria, only 5 (2.1%) presented with both microscopic hematuria and proteinuria.
At presentation 48.2% were on NSAIDs, 16 (6.9%) patients treated with methotrexate, 52(22.3%) were treated with anti-TNF, 26 (11.1%) continued on NSAID’s.
At last follow up: 32 (13.7%)patients had microscopic hematuria, 22 (9.4%) with proteinuria, and 7 (3%) with both microscopic hematuria and proteinuria.
eGFR at last follow up was 93.2 ml/mi (±22.3) compared to 97.1ml/min at presentation
only 2 patients underwent renal biopsy, both had concomitant IgA nephropathy in their biopsies.

Conclusion

Renal dysfunction is not uncommon in RA patients, though more careful evaluation and attention to urine analysis and microscopy for renal dysfunction is required

Baseline characteristics
Age54.5 (±47.2)
Male40(15.1%)
Female225(84.9%)
DM24(9.1%)
HTN41(15.5%)
ACEi/ARB24(9.1%)
eGFR97.1ml/min(±22.5)