Back to Search
Start Over
Increased Risk of Chronic Kidney Disease in Rheumatoid Arthritis Associated with Cardiovascular Complications - A National Population-Based Cohort Study.
- Source :
-
PloS one [PLoS One] 2015 Sep 25; Vol. 10 (9), pp. e0136508. Date of Electronic Publication: 2015 Sep 25 (Print Publication: 2015). - Publication Year :
- 2015
-
Abstract
- Background and Objectives: There have been few large population-based studies of the association between rheumatoid arthritis (RA) and chronic kidney disease (CKD) and glomerulonephritis. This nationwide cohort study investigated the risks of developing CKD and glomerulonephritis in patients with RA, and the associated risks for cardiovascular complications.<br />Methods: From the Taiwan National Health Insurance Research Database, we identified a study cohort of 12,579 patients with RA and randomly selected 37,737 subjects without RA as a control cohort. Each subject was individually followed for up for 5 years, and the risk of CKD was analyzed using Cox proportional hazards regression models.<br />Results: During the follow-up period, after adjusting for traditional cardiovascular risk factors RA was independently associated with a significantly increased risk of CKD (adjusted hazard ratio [aHR] 1.31; 95% confidence interval [CI] 1.23-1.40) and glomerulonephritis (aHR 1.55; 95% CI 1.37-1.76). Increased risk of CKD was also associated with the use of non-steroidal anti-inflammatory drugs, cyclosporine, glucocorticoids, mycophenolate mofetil, and cyclophosphamide. Patients with comorbidities had even greater increased risk of CKD. Moreover, RA patients with concurrent CKD had significantly higher likelihood of developing ischemic heart disease and stroke.<br />Conclusions: RA patients had higher risk of developing CKD and glomerulonephritis, independent of traditional cardiovascular risk factors. Their increased risk of CKD may be attributed to glomerulonephritis, chronic inflammation, comorbidities, and renal toxicity of antirheumatic drugs. Careful monitoring of renal function in RA patients and tight control of their comorbid diseases and cardiovascular risk factors are warranted.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Antirheumatic Agents adverse effects
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid drug therapy
Arthritis, Rheumatoid epidemiology
Cardiovascular Diseases epidemiology
Cohort Studies
Comorbidity
Databases, Factual
Female
Follow-Up Studies
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Renal Insufficiency, Chronic mortality
Risk
Taiwan epidemiology
Urbanization
Young Adult
Arthritis, Rheumatoid complications
Cardiovascular Diseases complications
Population Surveillance
Renal Insufficiency, Chronic epidemiology
Renal Insufficiency, Chronic etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 10
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 26406879
- Full Text :
- https://doi.org/10.1371/journal.pone.0136508