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In rheumatoid arthritis: traditional and non-traditional cardiovascular risk factors work collectively to determine renal function

Author: 
Suad Hannawi and Issa Al Salmi
Subject Area: 
Health Sciences
Abstract: 

Introduction: Patients with rheumatoid arthritis (RA) are more likely to developed reduced kidney function over time. Presence of cardiovascular diseases (CVD) appears to play a role. Also renal dysfunction in RA found to be associated with a higher risk of cardiovascular (CV) disease independently of traditional CV risk factors. On the other hand, presence of RA in individuals with reduced kidney function may lead to an increase in morbidity from CVD development. Objective of this article is to identify the determinants of kidney function; through measuring glomerular filtration rate (GFR) in RA population. Method: eighty RA participants, without CVD, cerebrovascular, diabetes or renal diseases were recruited. Univariate and multivariate linear regression were used to identify the determinants of GFR. Results: The mean age of the participants was 46 ±13 years, (71 female and 9 male). The mean GFR was 136 ± 50 ml/min/1.73m2. The factors that found to determine the GFR level in a negative linear trend were age of the participants (p< 0.001, CI: -0.021, -0.011), age at RA symptoms onset (p<0.001, CI: -0.016, -0.006), age at RA diagnosis (P<0.001, CI: -0.018, -0.008), systolic blood pressure; SBP (p=0.001, CI: -0.012, -0.0030), diastolic blood pressure; DBP (p=0.041, CI: -0.015, -0.000), body weight (p=0.008, CI: -0.010, -0.002), body mass index; BMI (p=0.033, CI: -0.033, -0.001), uric acid level (p<0.001, CI:-0.003, -0.001), erythrocytes sedimentation rate; ESR (p=0.033, CI -0.006, -0.000), c-reactive protein; CRP (p=0.034, CI: -0.006, -0.000), ferritin (p=0.007, CI: -0.003, -0.001), triglyceride; TG (p=0.008, CI -0.271, -0.042), urine microalbumin level (p=0.041, CI: -0.002, -0.000), and microalbumin creatinin ratio (p=0.008, -0.015, -0.002). Multiple model that included all the variables with a significant association with GFR in the univariate analysis showed that the GFR is determined by age, uric acid level, urine microalbumin, BMI, SBP, CRP and triglyceride level (R2=94). Conclusion: Renal function in RA is shaped by both traditional and non-traditional CVD risk factors. Therefore, traditional and non-traditional risk factor measurements may provide a means for optimizing care of RA patients and reducing mortality related to CV and renal diseases.

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