Chronic Kidney Disease And ​​Rheumatoid Arthritis

1 in 4 people with RA may develop chronic kidney disease (CKD)

People living with rheumatoid arthritis (RA) have chronic inflammation that causes joint pain and swelling. This inflammation can affect the kidneys. “Approximately 1 in 4 people with RA may develop chronic kidney disease (CKD). However, reducing the inflammation can reduce the risk of CKD progression.”

Most medications for rheumatoid arthritis are safe for the kidneys, but they may increase the risk of kidney disease in people with preexisting kidney problems. The more severe your disease, the higher your risk of poor kidney function. There is a strong link between RA and CKD.

The RA And CKD Link

The chronic inflammation associated with RA can damage blood vessels in the kidneys, leading to reduced kidney function. In people with kidney problems, medications for RA may also worsen kidney function. Managing RA and inflammation is important for protecting the kidneys.

There are several ways that rheumatoid arthritis contributes to chronic kidney disease:

• Plaque Buildup: Plaque builds as inflammation damages the lining of the blood vessels in the body (including the kidneys). This plaque then reduces the blood flow to the kidneys, limiting the oxygen they receive.

• Amyloidosis: This is a buildup of the protein amyloid in the kidneys, which can lead to reduced kidney function.

• Glomerulonephritis: Inflammation of the glomeruli, which helps to filter out waste from the blood. This reduces the function of the kidneys.

• Heart Problems: RA may cause high blood pressure. Over time, this can damage the blood vessels in the kidneys (they are less likely to remove waste and fluid from the body). Fluid buildup can increase blood pressure even further, which leads to a cycle that damages the kidneys.

• Rheumatoid Arthritis Medications: The kidneys may not be able to filter out the medications from the kidneys, thus causing further damage.

A Recent RA And Kidney Function Study

Researchers from the U.S. and Japan reviewed 21 years' worth of data for over 31,000 RA patients. “The study concluded that higher RA disease activity was associated with a drop in estimated glomerular filtration rate (eGFR) over time.” In this group, some patients were in remission or had low-moderate-high activity of the disease. 

Higher RA disease activity was associated with a decline in kidney function. With a median follow-up time of 3.5 years, “patients with higher RA disease activity again were more likely to progress to more severe CKD.” Patients with moderate or low RA disease activity were also more likely to have a decline in kidney function compared with patients in remission.

How To Protect The Kidneys

• Manage your RA: Managing inflammation can help protect the kidneys.

• Know medication side effects: Talk with your doctor about side effects and the potential risk of kidney decline.

• Get regular testing: Regularly test your blood and urine to check kidney levels.

• Manage blood pressure: This may require making lifestyle changes.

• Drink plenty of fluids: Fluids help the kidneys function normally.

• Limit salt intake: Excess salt will increase blood pressure.

Conclusion

The authors of the study concluded that “controlling disease activity may potentially contribute to preserving kidney function in patients with RA. As such, they recommend further studies to elucidate the role of different therapies and treatment strategies in kidney function preservation.”

To learn more about Chronic Kidney Disease, read HERE.