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Rheum Dis Clin North Am. 2018 Nov;44(4):571-584. doi: 10.1016/j.rdc.2018.06.008. Epub 2018 Sep 7.

Renal Manifestations of Rheumatoid Arthritis.

Author information

1
Department of Medicine, Division of Rheumatology, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA. Electronic address: Tmk2134@cumc.columbia.edu.
2
Department of Medicine, Division of Rheumatology, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.

Abstract

Renal manifestations in rheumatoid arthritis (RA) have evolved as RA management has improved. In the past, older disease-modifying antirheumatic drugs, uncontrolled systemic inflammation, and chronic nonsteroidal antiinflammatory drug (NSAID) use contributed to kidney disease. Over time, the use of methotrexate and biologic medications, decrease in NSAID use, and a treat-to-target strategy have contributed to a decrease in renal manifestations. Chronic kidney disease in RA now is more likely to be caused by cardiovascular risk factors than uncontrolled RA disease severity. In patients with renal dysfunction, NSAIDs, methotrexate, and tofacitinib may need to be adjusted or avoided to prevent adverse events.

KEYWORDS:

Chronic kidney disease in RA; DMARDs in CKD; RA; RA glomerulonephritis; Rheumatoid arthritis; Rheumatoid kidney; Rheumatoid nephropathy

PMID:
30274624
DOI:
10.1016/j.rdc.2018.06.008

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