Rheumatoid arthritis and kidneys: Protecting your kidneys from RA

Rheumatoid arthritis patients are at an increased risk for chronic kidney disease. Researchers at the Mayo Clinic have found that rheumatoid arthritis (RA) patients have a higher risk of chronic kidney disease (CKD) along with an increase in inflammation within the first year of diagnosis, corticosteroid usage, hypertension, and obesity. The researchers recommend that rheumatoid arthritis patients be tested periodically for signs of kidney problems. Patients should also work to manage blood pressure by avoiding high-salt diets and scaling back on medications that can harm the kidneys.

The study looked at 813 Mayo Clinic patients with rheumatoid arthritis and 813 patients without the condition. Over the course of 20 years, rheumatoid arthritis patients had a one in four chance of developing chronic kidney disease, in comparison to the general public who had a one in five chance.

Senior author Dr. Eric Matteson said, “That might not seem like a lot, but in fact that’s quite a big difference, and it has important implications for the course of rheumatoid arthritis and for the management of the disease.”

Heart disease was also found to be common in rheumatoid arthritis patients with chronic kidney disease.
Risk factors in rheumatoid arthritis patients for developing chronic kidney disease include corticosteroid use, severe inflammation, obesity, hypertension, and abnormally high cholesterol.

Dr. Matteson noted that there are currently no treatment guidelines for chronic kidney disease in rheumatoid arthritis, but he warns that doctors should be mindful of the medications they put RA patients on to reduce their risk of CKD. Furthermore, RA patients should undergo routine blood work and urine analysis to monitor kidney function. “Kidney disease in patients with rheumatoid arthritis can be detected very simply, and the techniques are the same as are used in the general population,” Dr. Matteson added.

To further reduce their risk of CKD, the patients should be watchful of their blood pressure and reduce their use of medications that can be toxic to the kidneys.

How rheumatoid arthritis affects your kidneys

Inflammation is the key component in the impact rheumatoid arthritis has on the kidneys. Normally, inflammation is a mechanism that the body utilizes to protect and heal the body, but chronic inflammation does far more harm than good, causing stress and destroying cells and tissue.

Other factors that contribute to a higher risk of chronic kidney disease in rheumatoid arthritis include obesity, hypertension, a corticosteroid medication, high cholesterol, and a high-salt diet.

Many of the risk factors for CKD in RA are modifiable, so it’s important that RA patients partake in the appropriate lifestyle changes in order to reduce their risk of chronic kidney disease.

Symptoms and risk factors of kidney disease with RA

The symptoms of kidney disease may be similar to those of RA and include fatigue, decreased appetite, itchy or darkened skin, muscle cramps, eye puffiness, shortness of breath, swollen feet and ankles, difficulty concentrating, trouble sleeping, and increased urination.

While there are no set standards for how often doctors should test patients with RA for kidney disease, it is likely your physician will begin testing you more often after being diagnosed with rheumatoid arthritis. Your risk for kidney disease also increases if you have diabetes, a family history of kidney disease, heart disease, high blood pressure and/or high cholesterol, so your doctor may test you more frequently if you have one or more of these conditions.

How to protect kidneys with RA

An RA diagnosis does not necessarily mean that you will definitely develop kidney disease. In fact, there are ways to protect your kidneys that include exercising regularly, eating a balanced, healthy diet with plenty of fresh produce, limiting your sodium intake, monitoring and controlling your cholesterol levels, and staying hydrated. Regular testing and checkups with your doctor can also help to keep your kidneys healthy and prevent your condition from worsening.