Renal involvement in rheumatoid arthritis

Abstract

Renal involvement is still a significant problem in rheumatoid arthritis (RA) patients. Reduced kidney function is detected in 5-50% of them and is more prevalent than in the general population. During the last decades the picture of renal disease has changed due to earlier and more aggressive therapy of arthritis. Nephrotoxic drugs are withdrawn or used very rarely. Because of successful reduction of the inflammatory process, amyloidosis has become rare, as have other severe complications of active disease such as vasculitis. Acute renal failure is now very infrequent, but chronic kidney disease (CKD) still makes an important contribution to morbidity and mortality. Recent studies are focused on the association between CKD and chronic cardiovascular disease (CVD). The relation appears comparable to the association observed in diabetes mellitus. In the article we summarize the results of studies on renal disease in RA, including histopathology, risk factors and markers of renal involvement.