Spectrum of glomerulonephritis in Egyptian patients with rheumatoid arthritis : a university hospital experience
Joint Authors
Hamzah, Wail M.
Shakir, Amr M.
Wadie, Mary
Fayid, Ahmad Hasan
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 30, Issue 4 (31 Aug. 2019), pp.803-811, 9 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2019-08-31
Country of Publication
Saudi Arabia
No. of Pages
9
Main Subjects
Topics
Abstract EN
Rheumatoid arthritis (RA) is accompanied by a variety of nephropathies.
It is often difficult to distinguish between disease-associated and drug-associated renal diseases.
Three hundred and seventy-six RA patients with renal involvement were included in our study; they were subjected to full history and clinical examination, kidney function, 24-h urinary protein, and kidney biopsy.
All our patients were on methotrexate, low dose steroids, and nonsteroidal antiinflammatory drugs, in addition to the previous medications.
About 79.3%, 20.7%, 6.9%, and 5.9% of our patients were on leflunomide, hydroxychloroquine, etanercept, and infliximab, respectively.
Renal presentation was in the form of nephrotic syndrome (33.5%), persistent subnephrotic proteinuria (12.2%), persistent proteinuria and recurrent hematuria (13.3%), acute nephritis (23.9), recurrent hematuria (7.4%), and creatinine >1.5 mg/dL (10.6%).
Renal biopsies were glomerular amyloidosis (28.1%), mesangioproliferative (19.1%), membranous (6.1%), crescent (16.8%), focal segmental glomerulosclerosis (18.6%), and minimal changes (11.7%).
There was a statistically significant difference in the incidence of membranous nephritis between patients who took leflunomide, and hydroxychloroquine and those did not.
Etanercept in our study seems not to be related to any form of renal involvement, while infliximab is related to focal segmental sclerosis and amyloidosis of tubulointerstitial type.
Kidney involvement in RA is not a rare complication.
Any type of histopathological changes can be present, with amyloidosis on top of the list.
Hydroxychloroquine and leflunomide are accused in membranous nephropathy.
Infliximab is associated with focal segmental sclerosis and amyloidosis of tubulointerstial type, and etanercept appear to be safe as regards kidney affection.
American Psychological Association (APA)
Fayid, Ahmad Hasan& Shakir, Amr M.& Hamzah, Wail M.& Wadie, Mary. 2019. Spectrum of glomerulonephritis in Egyptian patients with rheumatoid arthritis : a university hospital experience. Saudi Journal of Kidney Diseases and Transplantation،Vol. 30, no. 4, pp.803-811.
https://search.emarefa.net/detail/BIM-893636
Modern Language Association (MLA)
Fayid, Ahmad Hasan…[et al.]. Spectrum of glomerulonephritis in Egyptian patients with rheumatoid arthritis : a university hospital experience. Saudi Journal of Kidney Diseases and Transplantation Vol. 30, no. 4 (Jul. / Aug. 2019), pp.803-811.
https://search.emarefa.net/detail/BIM-893636
American Medical Association (AMA)
Fayid, Ahmad Hasan& Shakir, Amr M.& Hamzah, Wail M.& Wadie, Mary. Spectrum of glomerulonephritis in Egyptian patients with rheumatoid arthritis : a university hospital experience. Saudi Journal of Kidney Diseases and Transplantation. 2019. Vol. 30, no. 4, pp.803-811.
https://search.emarefa.net/detail/BIM-893636
Data Type
Journal Articles
Language
English
Record ID
BIM-893636