Abstract:

Objectives: The aim of this study was to observe the ef­fects of duration and severity of disease on renal func­tions and histopathology in patients with rheumatoid ar­thritis (RA). Material and methods: The study included 50 patients of RA, who were divided into two groups of 25 patients each. Disease severity was assessed by Disability Activi­ty Score (DAS). The renal parameters i.e., urine complete examination, blood urea, serum creatinine and creatinine clearance were estimated at enrolment. Percutaneous renal biopsy was performed in patients having active uri­nary sediment, haematuria and/or proteinuria more than 300 mg/day and serum creatinine more than 1.5 mg/ml. Results: Group I patients had duration of disease be­tween 2-5 years and in Group II the duration was more than 5 years. Urine abnormalities were documented in 28% RA patients and 12% patients had isolated hema­turia, 10% patients presented with isolated proteinurea and combined haematuria and proteinurea was present in 6% patients.14% patients presented with raised crea­tinine( >1.5mg/ml). Renal biopsy was performed in 20% of patients which showed mesangial glomerulonephritis, membranous glomerulonephritis, secondary amyloidosis and interstitial nephritis. In group I severe DAS score was present in 17% of the patient having urinary abnormality, however 20% patients showed histopathological findings. In group II 63% of patients with severe DAS score had urinary abnormality, 83% showed raised serum creatinine and 60% had histopathological abnormalities indicating severe DAS score and increased duration of disease was associated with significant effects on histofunctional sta­tus of kidney. Conclusion: There was a significant increase in renal dysfunction with duration and severity of disease in rheu­matoid arthritis.

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