Changes in renal function and morphological variations of kidney diseases in rheumatoid arthritis patients

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2024-04-01 DOI:10.1016/j.ajur.2022.06.005

Yan Tang , Yuliya Varavko , Raisa Aringazina , Irina Menshikova

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引用次数: 0

Abstract

Objective

Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis (RA) associated with a very unfavorable prognosis. This study aimed to identify changes in renal function and morphological variations of kidney diseases in RA patients.

Methods

The study enrolled patients (126 patients) between 18 and 55 years of age with a confirmed active RA of more than 12 months. Each patient underwent the following range of laboratory and instrumental research methods: general clinical analysis of blood and urine, performing urinalysis according to Nechiporenko method; determining daily proteinuria; determining the blood content of glucose, urea, creatinine, uric acid, total bilirubin, liver transaminase level, ionogram, lipidogram, and coagulogram; determining the blood content of rheumatoid factor, anti-streptolysin O, and C-reactive protein; and X-ray of the joints of hands and feet. Renal function was examined by estimating glomerular filtration rate, tubular reabsorption index, and renal functional reserve. For studying the morphological changes in the kidneys under ultrasound examination, renal biopsy was performed in 31 patients with RA with urinary syndrome (proteinuria more than 0.3 g per day and hematuria).

Results

Nephropathy in RA is characterized by impaired renal function and manifested by an increased blood creatinine and a decrease in glomerular filtration rate and renal functional reserve. Among morphological variations of nephropathy at RA, mesangial proliferative glomerulonephritis prevails, accounting for 48.4% of patients. Other disorders include the secondary amyloidosis (29.0% of patients), tubulointerstitial nephritis (16.1%), membranous glomerulonephritis (3.2%), and focal-segmental glomerulosclerosis (3.2%).

Conclusion

Kidney damage is a common systemic manifestation of RA with a long and active course, a major nephropathy trigger.

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RA患者肾功能变化及肾脏疾病形态学变化

目的类风湿肾病是类风湿性关节炎（RA）最严重的关节外表现之一，预后极差。本研究旨在确定 RA 患者肾功能的变化和肾脏疾病的形态学变化。研究方法：本研究招募了年龄在 18 岁至 55 岁之间、确诊活动性 RA 超过 12 个月的患者（126 名）。每位患者均接受了以下一系列实验室和仪器研究方法：血液和尿液的一般临床分析，根据 Nechiporenko 方法进行尿液分析；测定每日蛋白尿；测定血液中葡萄糖、尿素、肌酐、尿酸、总胆红素、肝脏转氨酶水平、离子图、血脂图和凝血图的含量；测定血液中类风湿因子、抗链球菌溶血素 O 和 C 反应蛋白的含量；以及手足关节的 X 光检查。通过估算肾小球滤过率、肾小管重吸收指数和肾功能储备来检查肾功能。为了研究超声检查下肾脏的形态学变化，对 31 名伴有泌尿系统综合征（蛋白尿超过每天 0.3 克且有血尿）的 RA 患者进行了肾活检。结果RA 肾病的特点是肾功能受损，表现为血肌酐升高、肾小球滤过率和肾功能储备下降。在 RA 肾病的形态变化中，系膜增生性肾小球肾炎占多数，占患者总数的 48.4%。其他疾病包括继发性淀粉样变性（29.0%的患者）、肾小管间质性肾炎（16.1%）、膜性肾小球肾炎（3.2%）和局灶性肾小球硬化（3.2%）。

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.