Kidney and Metabolic Bone Diseases Vol.23 No.4(8)

Theme Bone metabolism in rheumatoid arthritis
Title Renal diseases associated with rheumatoid arthritis
Publish Date 2010/10
Author Toru Mima Division of Nephrology and Blood Purification Medicine, Wakayama Medical University
Author Masaki Ohya Division of Nephrology and Blood Purification Medicine, Wakayama Medical University
Author Shigeo Negi Division of Nephrology and Blood Purification Medicine, Wakayama Medical University
Author Takashi Shigematsu Division of Nephrology and Blood Purification Medicine, Wakayama Medical University
[ Summary ] Rheumatoid arthritis (RA) is one of the most common systemic inflammatory diseases. For treatment of RA, disease modifying anti-rheumatic drugs (DMARDs) such as methotrexate are commonly used. Most of DMARDs are discharged from the body through the kidneys. Therefore, patients with RA who have renal dysfunction cannot receive adequate treatment. Renal diseases associated with RA are critical factors in the treatment of RA although the incident of these conditions is not high. Regarding renal diseases related to disease activity, mesangial proliferative glomerulonephritis and amyloidosis of the kidney are often observed in patients with RA. In RA patients with vasculitis, renal diseases may be observed. Moreover, RA patients with Sjögren's syndrome sometimes have interstitial nephritis and patients who are MPOANCA positive have acute progressive nephritis. Regarding renal diseases related to drugs used for treatment of RA, membranous nephropathy are often observed in patients receiving either bucillamine or gold, and interstitial nephritis is often observed in patients receiving NSAIDs. Therefore, a variety of renal diseases in patients with RA occurs due to various causes.
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