Kidneys and Rheumatoid Arthritis: What you need to know
Rheumatoid arthritis (RA) is a chronic, symmetric, polyarthritic but also systemic inflammatory disease, mainly affecting the small joints, especially the hands. It is an autoimmune disease in which the immune cells of the organism attack and destroy the healthy tissues of the body itself. If left untreated, inflammation can cause permanent damage to these joints.
Can RA affect my kidneys?
Scientific studies have shown that a patient with RA is more likely to develop some form of renal disease. About 1 in 4 people have impaired renal function in the long term.
What are the risk factors that can contribute to kidney disease in patients with RA?
The risk factors are the following:
- More intense inflammation within one year of RA diagnosis
- High blood pressure
- High cholesterol
- Diet rich in salt
- Chronic use of non-steroidal anti-inflammatory agents
How does RA affect my kidneys?
RA affects the kidneys due to:
- some medications used for it (mainly older ones)
- secondary amyloidosis
- the appearance of glomerulonephritis in the kidney
What is secondary amyloidosis?
This form of amyloidosis occurs in combination with chronic infections or inflammatory conditions (such as RA). It is more related to RA that has not been treated or has been partially treated for years, and with the newer treatments its appearance has been greatly reduced. The treatment of secondary amyloidosis is the treatment of the disease that created it (of RA).
Which glomerulonephritis is involved in kidney damage by RA?
Mesangial proliferative glomerulonephritis, rheumatoid vasculitis (vascular inflammation), membranous glomerulonephritis and diffuse proliferative glomerulonephritis. That is, RA can be involved in the development of specific lesions - glomerulonephritis in the kidney, whose diagnosis requires a kidney biopsy if there is suspicion of renal involvement. The nephrologist will then consult you for the appropriate treatment.
What can I do to protect my kidneys from RA?
The first step is to diagnose RA in a timely fashion and to begin the appropriate treatment to control the inflammation as soon as possible
- In general, the use of non-steroidal anti-inflammatory drugs should be avoided as far as possible since there are newer medications and more secure
- Daily exercise can keep all your organs and kidney in good condition (a 30-minute brisk walk is enough)
- Follow a diet rich in fruits and vegetables, low in fat and salt
- Regular monitoring of cholesterol levels and rapid treatment of hyperlipidemia are recommended
- Regular check of your kidney function is recommended
By the Scientific Director Aristides Paraskevopoulos
1.Hallowell RW, Horton MR. Interstitial lung disease in patients with rheumatoid arthritis: spontaneous and drug induced. Drugs. 2014 Mar;74(4):443-50. doi: 10.1007/s40265-014-0190-z. Review. PubMed PMID: 24570384.
2.Prete M, Racanelli V, Digiglio L, Vacca A, Dammacco F, Perosa F. Extra-articular manifestations of rheumatoid arthritis: An update. Autoimmun Rev. 2011 Dec;11(2):123-31. doi: 10.1016/j.autrev.2011.09.001. Epub 2011 Sep 10. Review. PubMed PMID: 21939785.
3.Icardi A, Araghi P, Ciabattoni M, Romano U, Lazzarini P, Bianchi G. [Kidney involvement in rheumatoid arthritis]. Reumatismo. 2003;55(2):76-85. Review. Italian. PubMed PMID: 12874640.
4.Schiff MH, Whelton A. Renal toxicity associated with disease-modifying antirheumatic drugs used for the treatment of rheumatoid arthritis. Semin Arthritis Rheum. 2000 Dec;30(3):196-208. Review. PubMed PMID: 11124283.
5.Boers M. Renal disorders in rheumatoid arthritis. Semin Arthritis Rheum. 1990 Aug;20(1):57-68. Review. PubMed PMID: 2218554.
6.Barba L, Pawlowski I, Brentjens JR, Andres GA. Diagnostic immunopathology of the kidney biopsy in rheumatic diseases. Hum Pathol. 1983 Apr;14(4):290-304. Review. PubMed PMID: 6219934.
7.Husby G. Amyloidosis in rheumatoid arthritis. Ann Clin Res. 1975 Jun;7(3):154-67. Review. PubMed PMID: 1103711.