Background The excess mortality associated with rheumatoid arthritis (RA) is due largely to cardiovascular disease. This highest risk is not related primarily to traditional cardiovasculr/atherosclerosis risk factors. The presence of RA indepedently, as well as high inflammation associated with RA has been reported as a cardiovascular risk factors. Also, subclinical decreased kidney function has been identified as an independent risk factor for CV events in patients with RA. The potential impact of impaired kidney function on atherosclerosis in RA requires more elucidation.
Objectives To assess the role of renal parameters, alongside with inflammation and traditional cardiovascular risk factors in predicting cardiovascular disease; as manifested by carotid intima media thickness (cIMT), among RA population.
Methods cIMT measurement was carried out in 68 RA patients, and correlated with renal function parameters with adjustment for traditional CV risk factors and RA associated inflammation. Glomerular filtration rate (GFR) was estimated with the abbreviated Modification of Diet in Renal Disease formula. Linear regression determined the association between renal parameters and the thickness of cIMT.
Results Carotid intima media thickness was positively associated with 1-demographic characteristics of the participants such as age of the participants (p<0.001), and age at RA sumptoms onset (p=0.001). 2-traditional cardiovascular risk factors such as systolic blood pressure (p<0.001), diastolic blood pressure (p=0.016), triglycerid level (p=0.016), and low densilty lipoprotein (LDL) (p=0.001). 3-inflammatory markers such as erythrocytes sedimentation rate (ESR) (p=0.020) and c-reactive protein (CRP) (0.020), and 4-renal function parameters such as uric acid level (p=0.006), urine microalbumin level (p=0.030). cIMT negativlely associated with high density lipoprotein (HDL) (p=0.037), 24 hours urine creatinine level (p=0.020) and glomerular filtration rate (p=0.008).
Conclusions Subclinical renal function in conjunction with tarditional and non-traditional cardiovascular risk factors work synergistically to accelerate atheroscrlerosis in RA population.
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Disclosure of Interest None declared