Background/Purpose: To assess the prevalence and associations of renal dysfunction in patients with rheumatoid arthritis (RA).

Methods: COMEDRA is a French nationwide cross-sectional multicentre study on comorbidities in RA. Renal function was assessed from the estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation. RA characteristics, risk factors for renal dysfunction (cardiovascular risk factors, medications) were collected in all participants.

Results: 931 of the 970 recruited patients, were analysed (female gender: 79.6%, age: 57.8 years, disease duration: 11.1 years, DAS28-erythrocyte sedimentation rate: 3.1). About 9 % of patients had an eGFR<60 ml/min/1.73m² and 9.9% of the patients had proteinuria (defined by positive dipstick testing). In the univariate analysis, age (p<0.001), the presence of hypertension (p<0.001), systolic blood pressure (p=0.03), and Framingham Risk score (p<0.001) were associated with an eGFR<60ml/min/1.73m². Renal dysfunction was not associated with gender (p=0.35), disease duration (p=0.91), disease activity (as assessed by DAS28-ESR: p=0.14), NSAID use (p=0.77), disease severity (erosions [p=0.9], joint replacement [p=0.6]) or RA medications (p=0.14). Two multivariate analysis models were constructed: Model A, without the Framingham risk score which showed that age (OR: 1.05; 95%CI [1.03-1.09]) and hypertension (OR: 2.5, 95%CI [1.5-4.3]); were predictive of an eGFR <60 ml/ min/1,73m²; Model B, which showed that the Framingham risk score was predictive of low eGFR (OR 1.06, 95%CI [1.03-1.09]).

Conclusion: Renal impairment is relatively common in RA and is associated with cardiovascular risk factors such as age, hypertension and the Framingham risk score but not with disease activity or severity.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-prevalence-of-renal-impairment-in-patients-with-rheumatoid-arthritis/