Background Impairment of the kidneys in case of rheumatoid artritis (RA) is one of the most severe complications and results in unfavourable prognoses.
Objectives To investigate intrarenal hemodynamics (IRHD) in patients with diverse clinical forms of RA.
Methods 43 RA patients were studied according to ACR criteria. Of them, there were 36 females and 7 males. The mean age was 47.8 years. The average duration of RA was 7.8 years. Extraarticular symptoms were revealed in 23 patients. 18 patients had arterial hypertension. 14 had steroid dependence. 11 patients had chronic nephropathy without kidney failure. 3 patients had secondary amyloidosis. IRHD was studied by means of renal functional reserve (RFR). RSR was studied by means of dynamic evaluation of glomerulofiltration with oral protein tests (0.7 gr of proteins per 1 kg of weight).
Results Disorders of IRHD (RFR < 5%) were revealed in 17 RA patients including 3 patients with secondary amyloidosis. Of note are the following clinical features of this group: in 11 patients, duration of RA was more than 12 years; 12 patients had other extra articular symptoms and arterial hypertension; IRHD disorders were revealed in 5 patients who had no clinical and laboratory renal abnormalities. Those 5 patients had pre-existing arterial hypertension, extra articular symptoms and RA duration was more than 10 years.
Conclusion IRHD disorders were revealed in severe cases of RA with signs of nephropathy. However, our findings of RFR disorders in patients, who had no nephropathy, required evaluation and estimation of IRHD in patients with RA duration over 10 years, associated arterial hypertension and extra articular symptoms.
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