The Connection Between Kidney Disease and RA
A growing number of studies show that kidney disease is more common among people with rheumatoid arthritis than in the general public. For example, one in four people with rheumatoid arthritis develops chronic kidney disease, compared with one in five people in the general population, according to a study published in 2014 in the American Journal of Kidney Diseases. Researchers also found that heart disease was more common among people with RA and kidney disease. People with rheumatoid arthritis already face a higher risk of heart disease and atherosclerosis (hardening of the arteries) that, in turn, can eventually impair kidney function. Kidney disease is a known risk factor for heart disease, yet the link between kidney disease and RA isn’t fully understood. The conditions may occur independently, or the two diseases may share a common autoimmune or inflammatory connection within the body. RELATED: High Blood Pressure Often Untreated With RA In most cases, kidney damage is a result of poorly controlled rheumatoid arthritis or the drugs used to treat it. “The relationship is usually not direct,” said Carmen Gota, MD, a rheumatologist at the Cleveland Clinic. She added that kidney disease among people with RA is usually a side effect of long-term use of rheumatoid arthritis drugs like corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen sodium, and celecoxib. These drugs can indirectly cause kidney damage by raising blood pressure levels and putting additional stress on the kidneys. Other rheumatoid arthritis drugs, such as methotrexate, can be toxic to the kidneys at high doses and are not recommend for people with existing kidney damage and RA.
How to Keep Your Kidneys Healthy With RA
The first step to maintaining your kidney health with rheumatoid arthritis is to get your RA diagnosed and treated early with the right drugs rather than just relying on NSAIDs to manage symptoms, Dr. Gota said. That’s because anti-inflammatory drugs don’t slow the course of the disease like disease-modifying anti-rheumatic drugs (DMARDs), which are not linked to kidney damage. Second, Gota said, early treatment of rheumatoid arthritis will help prevent cardiovascular disease and limit the chronic inflammation that leads to atherosclerosis and kidney damage. Other helpful tips for maintaining kidney health with RA include:
Exercise regularly to keep the kidneys and other organs functioning normally.Eat a heart-healthy, low-fat diet rich in fruits and vegetables.Limit your salt intake, which can raise blood pressure and cause kidney damage.Keep cholesterol levels under control to reduce the risk of heart disease and related kidney damage.
Kidney Disease Warning Signs
Although there are no formal guidelines for screening for kidney disease in people with rheumatoid arthritis, Gota said most rheumatologists routinely monitor kidney health and function in people with RA because some of the drugs used to treat it affect the kidneys. Early or moderate kidney disease often goes unnoticed because it rarely causes symptoms. That’s why regular kidney function tests are needed to monitor it. Your doctor measures kidney function with the glomerular filtration rate (GFR). The rate is calculated based on your blood creatinine level, your age, your gender, and other factors. As kidney disease progresses, you may notice symptoms such as fatigue, difficulty concentrating, trouble sleeping, muscle cramping, poor appetite, nausea, abdominal pain or discomfort, and a change in the volume of urine produced, according to the National Kidney Foundation. Other risk factors for chronic kidney disease include diabetes, high blood pressure, family history of kidney disease, advanced age, and being a member of certain ethnic groups with higher rates of diabetes and high blood pressure. Be sure your rheumatologist knows your family history and about any other medical conditions you may have.
