Evaluation of functional disability and its correlation with disease activity in rheumatoid arthritis

Abstract

Aim of the work: To assess the urological disorders in rheumatoid arthritis (RA) patients, analyse the risk factors and to find their relation to disease activity and functional status. Patients and methods: 291 RA patients (253 females and 38 males; F:M 6.7:1) and 242 matched controls were included. Urological disorders in the form of urinary tract infections (UTI), urolithiasis and acute urine retention (AUR) were assessed, risk factors were analysed. Disease activity score (DAS-28) and modified health assessment questionnaire (mHAQ) were calculated. Results: RA patients had more frequent urological disorders (38.14%) than controls (20.66%), more UTI (p < 0.001) and this difference persisted in females (p < 0.001). Urolithiasis tended to be more frequent in RA patients (p = 0.3); the difference was significant between the female patients and controls (p = 0.04). Urinary stones were comparable between the male patients and controls (p = 0.2). RA patients had more AUR (4.8%) than the controls (2.1%) (p = 0.07). Asthmatic patients particularly the females had more UTI (p = 0.001 and p < 0.001 respectively). UTIs were observed with higher steroid doses (p = 0.04) and urolithiasis were noticed more in hypertensive female patients (p = 0.03). Patients with higher DAS-28 and mHAQ developed more urological comorbidities (p0.49 and p = 0.82 respectively). UTI and urolithiasis were detected in patients with higher DAS 28 (p = 0.1 and p = 0.4 respectively). Conclusion: RA patients were found to have more urological disorders. Bronchial asthma, hypertension and higher steroid doses may increase risk for urinary comorbidities in RA. Patients with higher DAS28 and mHAQ had more urological comorbidities, however without statistically significant difference.