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


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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.

参考

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