Background Renal damage is one of most unfavourable prognostic factors in rheumatoid arthritis (RA). Most frequent pathology is renal amyloidosis. Rheumatic glomerulonephritis as a systemic manifestation of RA is infrequent. Important place belongs to renal exacerbations due to NSAIDs treatment and basic drugs.
Objectives To determine the character of renal damage in RA by the data of biopsy material.
Methods In the period from 1998 to 2000 in Rheumatological department of Ulianovsk Regional Hospital 10 RA pts with nephropathy symptoms were examined: proteinuria, azotemia, nephrotic syndrome with median disease duration of 17.7 ± 5.1 years. Appearing of symptoms of renal pathology was in 10.7 ± 3.5 years from RA onset. Pts did not have basic therapy; according to their condition – only NSAIDs (Diclofenac, Indomethacin). All pts had closed renal biopsy.
Results According to data of hystological analysis 4 pts demonstrated amyloid lesion, 4 – interstitial nephritis, 1 – mesangioproliferative glomerulonephritis, 1 – combination of amyloidosis and interstitial nephritis. In two cases renal damage was the reason for lethal outcome.
Conclusion Absence of basic therapy for a long period of time of the disease results in the development of extraarticular manifestations and RA complication – amyloid renal damage.