Can inflammation in rheumatoid arthritis patients lead to chronic kidney disease?

This study looked at the effect of inflammation on the development of chronic kidney disease in patients with rheumatoid arthritis. The authors concluded that patients with persistent inflammation are at a higher risk of developing chronic kidney disease. 

Patients with rheumatoid arthritis (RA) most often experience swelling and inflammation of their joints. This can lead to pain and limited mobility in day-to-day life. Inflammation can also affect other organs, including the heart, lungs, eyes and kidneys. Glomerulonephritis (inflammation of the kidneys) and amyloidosis (buildup of protein in the organs, including kidneys, which can lead to organ failure) are more common in RA patients than in the general population. The link between RA and chronic kidney disease (CKD) is not known.

It is believed that excessive inflammation seen in RA plays a part in the development of heart problems and liver and skeletal disease. It is also possible that this inflammation contributes to the high level of CKD seen in RA patients.  

345 patients with RA were included in this study. They were split into 3 groups depending on their level of inflammation seen in laboratory tests over 6 months. Group 1 showed no high levels of inflammation; group 2 had one or two high inflammation results and group 3 had consistently high levels of inflammation.

The average follow-up period across all patients was 89 months. Overall 14% of patients developed CKD: 7% of group 1, 14% of group 2 and 22% of group 3. Patients with persistently high levels of inflammation were 3 times more likely to develop CKD.

The authors also identified age, sex, hypertension, diabetes, weight and treatment type as risk factors for developing CKD. Patients receiving methotrexate (Rheumatrex) had a lower rate of CKD.

This study concluded that patients with rheumatoid arthritis who show persistently high levels of inflammation are at a significantly higher risk of developing CKD. 

Only 47 cases of CKD were seen in this study. A higher number of patients may give more significant results. 

Consult with your physician if you would like to discuss any health concerns you have relating to rheumatoid arthritis.