A STUDY OF MICROALBUMINURIA IN RHEUMATOID ARTHRITIS : A CORRELATION WITH DISEASE ACTIVITY

Abstract

Objective: In rheumatoid arthritis (RA), CRP and ESR are nearly always elevated and reflect the disease activity. But the role of microalbuminuria with disease activity in RA is not clear. We aimed to study the association of microalbuminuria with RA and its correlation with disease activity. Material & Methods: Sixty patients of RA satisfying 2010 ACR/EULAR classification criteria without renal involvement were enrolled in study. The patients were subjected to detailed clinical history and examination with special emphasis on evaluation for swollen and tender joint count. Chi Square/Fisher Exact test was used to find the association of clinical factors between patients with and without the presence of microalbuminuria. Student-t test was used to find the significance of investigation parameters between two groups of patients and p value of less than 0.05 was considered statistically significant. Results: Mean age of microalbuminuria positive patient was 42.14 +/- 11.03 vs. 43.33 +/- 11.50 in microalbuminuria negative group. Mean ESR, Mean CRP and Mean RA factor values were 83.71, 49.14 and 200.05, respectively, in microalbuminuria positive patients that was significantly higher as compared to microalbuminuria negative group. Severity of disease correlated with both CRP and Microalbuminuria. Conclusions: The renal involvement in RA is with both glomerular and tubular damage. Presence of microalbuminuria indicates severe disease activity and long standing RA. Microalbuminuria is a sensitive indicator of early subclinical renal dysfunction and drug induced renal damage in RA. Methods for microalbuminuria detection should routinely be used in all RA patients to detect renal involvement in initial phase to devise the most appropriate treatment.