Chronic Kidney Diseases, Renal Dysfunction, Rheumatoid Arthritis
Conditions
Keywords
Rheumatoid arthritis, Subclinical renal dysfunction, eGFR, Urine albumin-to-creatinine ratio
Brief summary
This comparative cross-sectional study aims to determine the prevalence of subclinical renal dysfunction in patients with rheumatoid arthritis and to evaluate its association with disease activity and inflammatory markers compared with age- and sex-matched healthy controls at Assiut University Hospitals.
Detailed description
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that may be associated with early renal involvement even before overt chronic kidney disease develops. Subclinical renal dysfunction refers to early impairment of renal function that is not detected by conventional serum creatinine alone. This hospital-based comparative cross-sectional study will include two groups: patients with rheumatoid arthritis diagnosed according to the 2010 ACR/EULAR classification criteria, and age- and sex-matched apparently healthy controls. All participants will undergo clinical assessment, disease activity evaluation using DAS28, laboratory investigations including estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR), and renal ultrasonography. The study will determine the prevalence of subclinical renal dysfunction and assess its association with disease activity, inflammatory markers, serological markers, disease duration, and treatment-related factors.
Interventions
None listed
Sponsors
Assiut University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older * For patient group: Diagnosis of rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria * For control group: Age- and sex-matched apparently healthy individuals with no history of autoimmune disease or chronic kidney disease * Willingness to provide written informed consent
Exclusion criteria
* Known chronic kidney disease * Acute kidney injury * Diabetes mellitus * Uncontrolled hypertension * Active urinary tract infection * Pregnancy * History of obstructive uropathy or renal stones * Systemic lupus erythematosus or other connective tissue diseases * Malignancy * Patients on maintenance hemodialysis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of subclinical renal dysfunction | Baseline | Proportion of participants with subclinical renal dysfunction, defined as the presence of reduced estimated glomerular filtration rate (eGFR \< 90 mL/min/1.73 m²) and/or elevated urine albumin-to-creatinine ratio (UACR ≥ 30 mg/g) in the absence of previously diagnosed chronic kidney disease. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of eGFR between groups | Baseline | Mean difference in estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation between rheumatoid arthritis patients and healthy controls. |
| Comparison of UACR between groups | Baseline | Difference in urine albumin-to-creatinine ratio (mg/g) between rheumatoid arthritis patients and healthy controls. |
| Correlation of subclinical renal dysfunction with disease activity | Baseline | Correlation coefficient between the presence of subclinical renal dysfunction and DAS28-ESR score (and DAS28-CRP), using Spearman or Pearson correlation as appropriate. |
| Correlation of subclinical renal dysfunction with inflammatory markers | Baseline | Correlation coefficient between the presence of subclinical renal dysfunction and levels of erythrocyte sedimentation rate (ESR, mm/h) and C-reactive protein (CRP, mg/L), using Spearman or Pearson correlation as appropriate.. |
| Independent predictors of subclinical renal dysfunction | Baseline | Odds ratios of clinical, inflammatory, serological, disease-related, and treatment-related factors for the presence of subclinical renal dysfunction using multivariable logistic regression analysis. |
Contacts
CONTACTNermeen E barsoum, resident
STUDY_CHAIREssam m abd elaziz, prof
Internal Medicine Department, Assiut University Hospitals, Assiut, Egypt
Outcome results
None listed