Frequency of Renal Function Parameter Abnormalities in Patients with Psoriatic Arthritis and Rheumatoid Arthritis: Real-World Evidence from Clinical Practice.

Fabiola Atzeni,Ignazio Francesco Masala,Javier Rodríguez-Carrio,Pietro Muto

doi:10.3390/jcm11041029

Abstract

Objective: Patients with psoriatic arthritis (PsA) or rheumatoid arthritis (RA) commonly develop renal dysfunction due to either systemic inflammation or drug-related nephrotoxicity. This study compared renal function parameters in patients with PsA versus those with RA and examined the impact of clinical remission or disease relapse on renal function. Methods: This single-center retrospective study was conducted at the University Hospital of Messina, Italy. Adult patients (aged ≥18 years) with PsA or RA who attended the rheumatology clinic within the past 6 months were identified from electronic medical records. Results: In total, 45 patients with PsA (n = 23) or RA (n = 22) were included. The mean (standard deviation) age was 55.6 (15.9) years, and 78% of participants were female. Patient age, renal function, and medical history were generally similar between the two disease groups, although significantly more RA patients were smokers, and more PsA patients had comorbid hypertension. The prevalence of estimated glomerular filtration rate [eGFR] ≤90 mL/min/1.73 m2 at 1, 6, and 12 months of treatment ranged from 38.5% to 58.3% in the PsA group and from 45.5% to 54.5% in the RA group and did not significantly differ between disease groups. Clinical remission did not appear to affect renal function parameters in either disease group; however, relapse was associated with significantly higher serum creatinine levels in PsA patients at the same timepoint. Conclusion: In this study, patients with PsA and RA had a similar prevalence of renal function parameter abnormalities over 12 months of treatment. Disease relapse may impact renal function in patients with PsA.

Highlights

IntroductionPatients with rheumatoid arthritis (RA) commonly develop renal involvement, which may be disease-related (i.e., associated with systemic inflammation) or drug-related (i.e., occurring as a result of nephrotoxicity) [1,2]
Patients with rheumatoid arthritis (RA) commonly develop renal involvement, which may be disease-related or drug-related [1,2]
Drug-induced nephrotoxicity commonly develops with some older conventional disease-modifying antirheumatic drugs, such as penicillamine, cyclosporine, and gold, as well as with nonsteroidal anti-inflammatory drugs (NSAIDs), it has become less prevalent with the availability of less nephrotoxic cDMARDs and biologic agents [1]

Summary

Introduction

Patients with rheumatoid arthritis (RA) commonly develop renal involvement, which may be disease-related (i.e., associated with systemic inflammation) or drug-related (i.e., occurring as a result of nephrotoxicity) [1,2]. Drug-induced nephrotoxicity commonly develops with some older conventional disease-modifying antirheumatic drugs (cDMARDs), such as penicillamine, cyclosporine, and gold, as well as with nonsteroidal anti-inflammatory drugs (NSAIDs), it has become less prevalent with the availability of less nephrotoxic cDMARDs and biologic agents [1]. A common cause of renal involvement in patients with RA is amyloidosis [3]. In several reports of patients with amyloidosis, RA was the second most common cause of amyloidosis after infections [4,5]. It has been suggested that antitumor necrosis factor (TNF) agents in particular may prevent or ameliorate amyloidosis [7,8]

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