Increased Risk of Chronic Kidney Disease in Rheumatoid Arthritis Associated with Cardiovascular Complications – A National Population-Based Cohort Study
| Autor: | Hung An Chen, Shinn-Ying Ho, Chien Hsun Li, Shih Hsiang Chiu, Tsen-Fang Tsai, Hui Ling Huang, Wei Chun Lin, Yu Pin Cheng, Chia Lun Yeh, Hsien-Yi Chiu |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Adolescent Databases Factual Taiwan Arthritis lcsh:Medicine Comorbidity Kaplan-Meier Estimate urologic and male genital diseases Arthritis Rheumatoid Cohort Studies Young Adult Internal medicine Diabetes mellitus medicine Humans Renal Insufficiency Chronic lcsh:Science Aged Proportional Hazards Models Aged 80 and over Multidisciplinary business.industry Incidence (epidemiology) Incidence lcsh:R Urbanization Glomerulonephritis Middle Aged medicine.disease female genital diseases and pregnancy complications Cardiovascular Diseases Rheumatoid arthritis Antirheumatic Agents Population Surveillance Physical therapy lcsh:Q Female business Cohort study Kidney disease Research Article Follow-Up Studies |
| Zdroj: | PLoS ONE PLoS ONE, Vol 10, Iss 9, p e0136508 (2015) |
| ISSN: | 1932-6203 |
| Popis: | 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. 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. 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. 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. |
| Databáze: | OpenAIRE |
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