Journal
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA
Volume 44, Issue 4, Pages 571-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.rdc.2018.06.008
Keywords
Rheumatoid arthritis; RA; Rheumatoid nephropathy; Rheumatoid kidney; RA glomerulonephritis; Chronic kidney disease in RA; DMARDs in CKD
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Renal manifestations in rheumatoid arthritis (RA) have evolved as RA management has improved. In the past, older disease-modifying antirheumatic drugs, uncontrolled systemic inflammation, and chronic nonsteroidal anti-inflammatory drug (NSAID) use contributed to kidney disease. Over time, the use of methotrexate and biologic medications, decrease in NSAID use, and a treat-to-target strategy have contributed to a decrease in renal manifestations. Chronic kidney disease in RA now is more likely to be caused by cardiovascular risk factors than uncontrolled RA disease severity. In patients with renal dysfunction, NSAIDs, methotrexate, and to-facitinib may need to be adjusted or avoided to prevent adverse events.
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