AB0304 CHRONIC KIDNEY DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A RETROSPECTIVE COHORT STUDY

Abstract

BackgroundPrevalence and incidence estimates for chronic kidney disease (CKD) in rheumatoid arthritis (RA) vary and it may result from comorbidities, chronic inflammation, aging, or effects of drugs used for the disease.ObjectivesTo calculate the prevalence and incidence of CKD in a cohort of patients with RA.MethodsThis was a retrospective cohort study in which well-characterized patients with RA (fulfillment of 1987 ACR criteria) were included from 2014 to 2021. Patients were evaluated at a single rheumatology outpatient center in Bogotá, Colombia. Baseline and follow-up estimated glomerular filtration rate (eGFR) were calculated according to CKD-EPI equation. CKD was defined as an eGFR <60 mL/min/1.73 m2.ResultsA total of 783 outpatients were included. Baseline characteristics were as follows: female gender 81.6%, mean age 51.8±11 years, mean disease duration 8 (IQR 3-15) years, RF positive 80.1%, ACPA positive 58.2%, and erosions 24.9%. Most patients have received glucocorticoids (89.8%), and conventional synthetic DMARDs (97.8%), being prednisone and methotrexate the most frequently prescribed. Hypertension was the most frequent comorbidity (27.7%). CKD was found in 43 (5.5%) patients at the time of inclusion, being hypertension the most common cause (24, 55.8%). Only 12 (1.5%) patients had a documented history of CKD at the beginning of the follow-up. The median of follow-up was 73 months. Fifteen incident cases of CKD were found (15/358, 4.1%) in patients with follow-up data of at least 1 year and without prior CKD. Main characteristics of the patients are shown in Table 1.Table 1.Cardiovascular disease and main comorbidities in RA patients.Baseline (n/783)Prevalent CKD (n/43)Incident CKD (n/15)Cardiovascular Diseasen (%)n (%)n (%)Hypertension217 (27,7)24 (56)6 (40)Coronary artery disease27 (3,4)3 (7)2 (13)Thrombosis14 (1,8)2 (5)2 (13)Stroke11 (1,4)1 (2)-Chronic occlusive arterial disease4 (0.5)1 (2)1 (7)Comorbidityn (%)n (%)n (%)Dyslipidemia209 (26,7)16 (37)9 (60)Diabetes mellitus type 255 (7)3 (7)-ConclusionThere is an underestimation of the prevalence of CKD in patients with RA in routine clinical practice due to the absence of a systematic estimation of eGFR. The incidence of CKD is low in the Colombian population.References[1]Hickson LJ, Crowson CS, Gabriel SE, McCarthy JT, Matteson EL. Development of reduced kidney function in rheumatoid arthritis. Am J Kidney Dis. 2014;63(2):206-13.[2]Couderc M, Tatar Z, Pereira B, Tiple A, Gilson M, Fautrel B, et al. Prevalence of Renal Impairment in Patients With Rheumatoid Arthritis: Results From a Cross-Sectional Multicenter Study. Arthritis Care Res (Hoboken). 2016;68(5):638-44.Disclosure of InterestsNone declared