Characteristics of renal tubule-interstitial dysfunction in patients with rheumatoid arthritis


A.P. Rebrov, M.A. Tiapkina, E.V. Voloshinova

State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky, Russia, Saratov
Aim. Characteristics of tubulointerstitial dysfunction in patients with rheumatoid arthritis (RA).
Methods. 75 patients with RA (age 18 – 60 years) were included into the study.
After screening, 51 patient without kidney diseases, arterial hypertension III stage and non-pregnant were included into the study. Tubulo-interstitial disfunction was detected by determination of urinary level of α1-microglobulin and activity of gamma-glutamiltranspeptidase (G-GT) and lactat-dehydrogenase (LDH) in the urine. Albuminuria and estimated glomerular filtration rate (eGFR, MDRD formula) were also determined.
Results. In patients with RA markers of tubulo-interstitial dysfunction can be found, which appears earlier, than markers of glomerular damage. Urinary level of α1-microglobulin can be considered as one of the most sensitive markers of tubulo-interstitial disfunction in patients with RA. In late stages of kidney damage, associated with RA, markers of tubulo-interstitial and glomerular involvment exists simultaneously. Signs of kidney damage were associated with X-ray stage of RA, as well as with frequency and duration of NSAIDs intake.
Conclusion. Tubulo-interstitial disfucntion can be found in most of patients with RA and can be considered as one of the early signs of kidney damage.

About the Autors


Rebrov A.P. – professor, honored physician of Russian Federation, head of hospital therapy department of Medical Faculty, vice-rector on medical work and post diploma education at State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky, Ph.D.;
E-mail: rebrov_ap@sgmu.ru;
Tiapkina M.A. – assistant at hospital therapy department of Medical Faculty State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky;

Voloshinova E.V. - assistant at hospital therapy department of Medical Faculty State Budgetary Educational Institution of High Professional Education Saratov State Medical University named after V. I. Razumovsky, Ph.D.


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