Renal Manifestations of Rheumatoid Arthritis

Kapoor, Teja; Bathon, Joan M.

doi:10.1016/j.rdc.2018.06.008

Cited by 49 publications

(47 citation statements)

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“…Rheumatoid arthritis (RA) is a chronic progressive immune‐inflammatory multisystem disorder that causes synovitis, articular and bone destruction, 1 and is associated with several systemic manifestations, including renal and pulmonary diseases, 2,3 cardiovascular disorders, 4 and infections 5 . RA affects up to 1.5% of the general population worldwide, can present at any age, and is more frequent in women than in men 6 .…”

Section: Introductionmentioning

confidence: 99%

A randomized, double‐blind, placebo‐controlled clinical trial, evaluating the garlic supplement effects on some serum biomarkers of oxidative stress, and quality of life in women with rheumatoid arthritis

2020

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Aim Rheumatoid arthritis (RA), is a prevalent immune‐inflammatory disease, which is associated with disabling pain. Oxidative stress might play a role in RA pathogenesis and outcomes. According to the antioxidant properties of garlic, the current study was performed to evaluate the garlic supplement effects on some serum levels of oxidative stress biomarkers, and quality of life in patients with rheumatoid arthritis. Methods Seventy women with RA participated in this randomized, double‐blind, placebo‐controlled, parallel‐design trial. The patients were randomly divided into two groups, receiving two tablets of either 500 mg garlic or placebo daily for 8 weeks. Serum levels of total antioxidant capacity (TAC) and malondialdehyde (MDA) and quality of life were determined at baseline and end of week 8. A health assessment questionnaire (HAQ) was used to evaluate the quality of life related to health. Results Of 70 patients enrolled in the trial, 62 subjects were included in the final analysis. At the end of the study, there was a significant increase in serum levels of TAC in the garlic group as compared with the placebo group (26.58 ± 77.30 nmol of Trolox equivalent/ml vs 16.11 ± 0.92 nmol of Trolox equivalent/mL; P = .026). In addition, MDA levels were significantly decreased in the intervention group compared with the control group (−0.82 ± 1.99 nmol/mL vs 0.36 ± 2.57 nmol/mL; P = .032). Pain after activity and HAQ scores decreased in the garlic group compared with the placebo (−11.96 ± 13.43 mm vs −0.06 ± 13.41 mm; P < .001, 0.17 ± 20 vs 0.05 ± 0.15; P < .001, respectively). Conclusions The findings suggest that garlic supplementation for 8 weeks resulted in significant improvements in oxidative stress, HAQ in women with RA.

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Section: Introductionmentioning

confidence: 99%

A randomized, double‐blind, placebo‐controlled clinical trial, evaluating the garlic supplement effects on some serum biomarkers of oxidative stress, and quality of life in women with rheumatoid arthritis

2020

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“…Возможные варианты поражения почек при РА включают в себя гломерулонефрит, ААамилоидоз, ревматоидный васкулит и различные формы лекарственной нефропатии (табл. 1) [30]. В отличие от СКВ, хронический гломерулонефрит при РА встречается редко, в то время как частота АА-амилоидоза при этом заболевании, наоборот, выше, чем при СКВ.…”

Section: рис 1 ра-изл с паттерном обычной интерстициальной пневмониunclassified

“…Клинические проявления поражения почек включают в себя протеинурию, изменения мочевого осадка и/или снижение расчетной скорости клубочковой фильтрации. Нарастающая протеинурия с развитием нефротического синдрома, не сопровождающаяся изменениями мочевого осадка и артериальной гипертонией, наблюдается при амилоидозе почек, а также при мембранозной нефропатии, в то время как мезангиопролиферативный гломерулонефрит при РА обычно характеризуется легким течением и редким развитием нефротического синдрома и хронической почечной недостаточности [30]. Следует отметить, что изменения в моче и клинические симптомы не позволяют надежно предсказать тип поражения почек при РА, поэтому пациентам с необъяснимыми протеинурией и хронической болезнью почек показана биопсия почки.…”

Section: рис 1 ра-изл с паттерном обычной интерстициальной пневмониunclassified

“…Наличие ХБП следует учитывать при выборе противовоспалительных препаратов и их доз. Например, метотрексат и НПВП противопоказаны больным с клиренсом креатинина ≤30 мл/мин, а дозу тофацитиниба следует снизить до 5 мг один раз в день у пациентов с клиренсом креатинина ≤50 мл/мин [30]. В то же время коррекция доз ГИБП, в том числе ингибиторов ФНОα, ритуксимаба, П.И.…”

Section: рис 1 ра-изл с паттерном обычной интерстициальной пневмониunclassified

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Extraarticular (systemic) manifestations of rheumatoid arthritis

Moiseev¹,

Novikov²,

Рамеев³

et al. 2020

CPT

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“…In the pre-methotrexate era, secondary amyloidosis was reported to be a major cause of chronic kidney disease (CKD) in patients with RA who had a prolonged disease course and high inflammatory markers. Long-term use of the nonsteroidal anti-inflammatory drug (NSAIDs) and traditional disease-modifying anti-rheumatic drugs (DMARDs) including penicillamine and gold are known to be responsible for most types of glomerular disease in patients with RA [ 1 ]. Other than glomerulonephritis secondary to chronic medication use, glomerular pathology has rarely been reported to be from a direct immune-mediated mechanism in patients with RA.…”

Section: Introductionmentioning

confidence: 99%

Case report: a man with untreated rheumatoid arthritis, cryoglobulinemic vasculitis, membranous nephropathy and pulmonary sarcoidosis

2020

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Background Glomerular involvement in rheumatoid arthritis has been known to be associated with treatment side effects from medications and secondary amyloidosis. However, limited basic science and clinical studies have been performed to address the potential disease specific immune-mediated mechanisms causing secondary glomerular pathology, its various types of presentation, and the potential treatments. Case presentation A 41-year-old man with chronic active rheumatoid arthritis presented with nephrotic syndrome and was found to have membranous nephropathy with eosinophilic intracapillary thrombi on renal biopsy. Proteinuria persisted despite complete withdrawal from non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs). Throughout the disease course, he developed cryoglobulinemic vasculitis and pulmonary sarcoidosis, both of which achieved clinical resolution with glucocorticoids. However, only partial improvement was observed in proteinuria with treatment of steroids and Rituximab. Conclusion Our case presented a unique and complicated clinical phenotype of active rheumatoid arthritis, with clinical features of cryoglobulinemic vasculitis, histopathologic features of membranous and cryoglobulinemic nephropathy in the absence of DMARDs use, as well as pulmonary sarcoidosis. We speculate that there is a wider spectrum of glomerular disease in patients with untreated rheumatoid arthritis. In addition, the potential association between rheumatoid arthritis and cryoglobulinemic vasculitis should probably be revisited and requires further studies to elucidate the underlying mechanisms and treatment options.

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Renal Manifestations of Rheumatoid Arthritis

Cited by 49 publications

References 65 publications

A randomized, double‐blind, placebo‐controlled clinical trial, evaluating the garlic supplement effects on some serum biomarkers of oxidative stress, and quality of life in women with rheumatoid arthritis

A randomized, double‐blind, placebo‐controlled clinical trial, evaluating the garlic supplement effects on some serum biomarkers of oxidative stress, and quality of life in women with rheumatoid arthritis

Extraarticular (systemic) manifestations of rheumatoid arthritis

Case report: a man with untreated rheumatoid arthritis, cryoglobulinemic vasculitis, membranous nephropathy and pulmonary sarcoidosis

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