Inflammatory processes activity and renal dysfunction pathogenic correlation in patients with early rheumatoid arthritis
DOI:
https://doi.org/10.14739/2310-1210.2017.1.91631Keywords:
beta-2-miсroglobulinuria, early rheumatoid arthritis, regression analysis, tumor necrosis factor-α, nephropathyAbstract
Relevance. Kidney damage is often associated with severe RA. This fact determines the need for monitoring of renal function in these patients, leads to scientific interest in the problems of nephrology at the RA. Studies devoted to the study of kidney disease in patients with RA, which would reflect the influence of clinical, laboratory and instrumental data on the formation of renal dysfunction are few or contradictory, that determined the urgency of further study of the problem.
The aim: to investigate pathophysiological contingency between activation of cell-mediated immunity (inflammatory cytokines) – tumor necrosis factor-alpha (TNF-α) and violations of renal function in patients at the onset of rheumatoid arthritis.
Materials and methods. This study included 35 patients aged over 18 years, with early rheumatoid arthritis (RA) (duration of symptoms was less than 12 months). The average age of patient was 50.71 ± 2.25 years (range from 18 to 76 years), 80 % of them were women, the mean duration of the disease at the time of the initial study was 9.21±0.43 months.
Results. At the initial examination in the studied patients it was showed that patients with early RA were characterized by the presence of renal dysfunction, which manifested with the reduction of glomerular filtration rate and increased excretion of urine protein. Dynamics of albuminuria, according to the analysis of variance for one-factor scheme, significantly determined by the degree of disease activity, reflecting the severity of joint inflammation. High level of β-2-mikroglobulin in urine significantly correlated with the levels of main cytokines expression– TNF-α according to the binary regression analysis, the relationship was a logarithmic dependence.
Conclusion. The obtained dependence showed that dynamics of expression of tubular disorders in RA was characterized by progressive deterioration depending on the degree of TNF-α expression, and the greatest increase in function (changing of the urine miсroglobulin) indicated in the interval from 200 to 350 pg/mL of the TNF-α level. According to the chi-square test, in patients with TNF-α level more than 250 pg/ml, the number of reported cases of microalbuminuria were significantly higher than at a lower level of TNF-α (p < 0.01).
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