Characteristics of renal tubule-interstitial dysfunction in patients with rheumatoid arthritis


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Abstract

Aim. Characteristics of tubulointerstitial dysfunction in patients with rheumatoid arthritis (RA).
Methods. 75 patients with RA (age 18 - 60 years) were included into the study.
After screening, 51 patient without kidney diseases, arterial hypertension III stage and non-pregnant were included into the study. Tubulo-interstitial disfunction was detected by determination of urinary level of α1-microglobulin and activity of gamma-glutamiltranspeptidase (G-GT) and lactat-dehydrogenase (LDH) in the urine. Albuminuria and estimated glomerular filtration rate (eGFR, MDRD formula) were also determined.
Results. In patients with RA markers of tubulo-interstitial dysfunction can be found, which appears earlier, than markers of glomerular damage. Urinary level of α1-microglobulin can be considered as one of the most sensitive markers of tubulo-interstitial disfunction in patients with RA. In late stages of kidney damage, associated with RA, markers of tubulo-interstitial and glomerular involvment exists simultaneously. Signs of kidney damage were associated with X-ray stage of RA, as well as with frequency and duration of NSAIDs intake.
Conclusion. Tubulo-interstitial disfucntion can be found in most of patients with RA and can be considered as one of the early signs of kidney damage.

References

  1. Насонов Е.Л., Каратеев Д.Е., Балабанова Р. М. Ревматоидный артрит В: Е. Л. Насонов, В. А. Насонова (ред.) Ревматология. Национальное руководство. М.: ГЭОТАР-Медиа. 2008. 290 - 331.
  2. Maradit-Kremers H., Nicola P.J., Crowson C.S. et al. Cardiovascular death in rheumatoid arthritis: A population - based study. Arthritis Rheum 2005; 52:722-732.
  3. Caplan M. J. Cardiovascular disease in rheumatoid arthritis. Currrent Opinion in Rheumatology, 2006;18: 289-97.
  4. Goodson NJ, Silman AJ, Pattison DJ, et al. Traditional cardiovascular risk factors measured prior to the onset of inflammatory polyarthritis. Rheumatology, 2004; 43: 731-736.
  5. Никитина Н. М., Ребров А. П. Определение риска развития сердечно-сосудистых заболеваний у больных ревматоидным артритом. Терапевтический архив 2009;6:29-34.
  6. Leuven S.L., Franssen R., Kastelein J.J. et al. Systemic inflammation as a risk factor for atherothrombosis. Rheumatology 2008;47:3-7.
  7. Мухин Н. А., Фомин В. В., Моисеев С. В. Микроальбуминурия - универсальный маркер неблагоприятного прогноза. Клиническая медицина 2008; 11:4-9.
  8. Astor B.C., Hallan S.I.Miller E.R. et al. Glomerular filtration rate, albumin ria, and risk of cardiovascular and all-cause mortality in the US population. American Journal of Epidemiology 2008;167:1226-1233.
  9. Функциональное состояние почек и прогнозирование сердечно-сосудистого риска. Национальные рекомендации по лечению. Кардиоваскулярная терапия и профилактика. 2008;7(6, прил.3).
  10. Киршина Н. С., Пименов Л.Т. Этапность развития дисфункции почек и анемии у больных с хронической сердечной недостаточностью. Российский кардиологический журнал 2009;3:21-25.
  11. А. Э. Мационис, М. М. Батюшин, П. Е. Повилайтите и соавт. Морфологический анализ патологических изменений в почках в зависимости от длительности артериальной гипертензии. Нефрология 2007;20(3):53-56.
  12. Vallon V., Richter K., Blantz RC et al. Glomerular hyperfiltration in experimental diabetes mellitus: potential role of tubular reabsorbtion. Journal American Sociently Nephrology 1999;10(12):2569-2576.
  13. Everaent K., Delanghe J., Vande Wiele C. Urinary alpha 1- microglobulin detects uropathy. A prospective study in 183 patients. Clinical Chemistry and laboratory medicine 1998; 36(5): 309-315
  14. D-Amico G., Bazzi C. Urinary protein and enzyme excretion as markers of tubular damage . Current Opinion in nephrology and hypertension 2003; 12 (6): 639-643.

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