Abstract
Objective
To determine the prevalence and associated factors of kidney disease in Korean rheumatoid arthritis (RA) patient, and describe the profile of RA drugs prescribed in RA patients.
Methods
A total of 284 patients at the division of rheumatology with confirmed RA were prospectively included in this study from May 1 to August 31, 2008. Renal function was assessed using Cockcroft-Gault (CG) and abbreviated Modification of Diet in Renal Disease (aMDRD) study formulae, and classified by the National Kidney Foundation (NKF) classification. Comparisons was were performed by the two sample t-test, chi-square-test and binary logistic regression analysis.
Results
Of 281 patients with RA, only 7 (2.5%) patients had abnormal serum creatinine (sCr) levels. According to the NFK classification, the prevalence of kidney disease using aMDRD and CG formula was 23.8% and 31.7%, respectively. Among the patients with eGRF <60 mL/min/m2 according to aMDRD or CG formulae, 91.8∼100% received at least one drug that was potentially nephrotoxic. RA patients with renal dysfunction was associated with advanced age, body mass index (BMI), antinuclear antibody (ANA).
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Table 1.
Table 2
Stage | GFR (mL/min/1.73 m2) | aMDRD fomula | Cock-Croft Gault formula | ||
---|---|---|---|---|---|
n (%) | No. of abnormal Cr | n (%) | No. of abnormal Cr | ||
Normal | ≥60 without evidence of kidney damage∗ | 214 (76.2) | 0 | 192 (68.3) | 0 |
Stage 1 | ≥90+Kidney damage | 36 (12.8) | 0 | 24 (8.5) | 0 |
Stage 2 | 60∼89+Kidney damage | 11 (3.9) | 0 | 17 (6.0) | 0 |
Stage 3 | 30∼59 | 16 (5.7) | 3 | 44 (15.7) | 3 |
Stage 4 | 15∼29 | 1 (0.4) | 1 | 3 (1.1) | 3 |
Stage 5 | <15 | 3 (1.1) | 3 | 1 (0.4) | 1 |
Table 3.
Data are presented as n (%) or mean± SD. GFR: glomerular filtration rate, CG: Cock-Croft Gault formula, BMI: body mass index, RA: rheumatoid arthritis, RF: rheumatoid factor, ANA: antinuclear antibody, CRP: c-reactive protein, ESR: erythrocyte sedimentation rate, DAS28: disease activity score 28, HAQ-DI: health assessment questionnaire-disability index, NSAIDs: non-steroid antiinflammatory drugs, MTX: methotrexate.