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Abstract Number: 1413

The Prevalence of Renal Impairment in Patients with Rheumatoid Arthritis

Marion Couderc Sr.1, Martin Soubrier2, Bruno Pereira3, Aurelien Tiple4, Melanie Gilson5, Bruno Fautrel6, Sophie Pouplin7, Emmanuelle Dernis Labous8, Laure Gossec9, Cécile Gaujoux-Viala10 and Maxime Dougados11, 1Chu G.Montpied, Clermont Ferrand, France, 2Rheumatology, CHU G.-Montpied, Clermont-Ferrand, France, 3Clinical research department, Clermont-Ferrand, France, 4Nephrology, CHU, Clermont-Ferrand, France, 5Rheumatology, CHu Grenoble, Grenoble, France, 6Rheumatology, Pitie Salpetriere Hospital, Paris, France, 7Rheumatology, Rouen University Hospital, Rouen, France, 8Rhumatologie, Ch Du Mans, Le Mans, France, 9Rheumatology, UPMC GRC08, Paris 06 University, Pitié Salpétrière Hospital, Paris, France, 10EA 2415, Montpellier I University, Nîmes University Hospital, Rheumatology Department, Nîmes, France, 11Université Paris René Descartes and Hôpital Cochin, Paris, France

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Cardiovascular disease, renal disease and rheumatoid arthritis (RA)

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Session Information

Session Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Comorbidities, Treatment Outcomes and Mortality

Session Type: Abstract Submissions (ACR)

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.


Disclosure:

M. Couderc Sr.,
None;

M. Soubrier,
None;

B. Pereira,
None;

A. Tiple,
None;

M. Gilson,
None;

B. Fautrel,
None;

S. Pouplin,
None;

E. Dernis Labous,
None;

L. Gossec,
None;

C. Gaujoux-Viala,
None;

M. Dougados,
None.

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