Symmetric dimethyl arginine and N-acetyl-β-D-glucosaminidase lysozimuria of proximal renal tubules as a target for nephrotoxicity in patients with rheumatoid arthritis treated with disease modifying antirheumatic drugs.
BACKGROUND
The aim of this study was to determine the effect of initial therapy with some disease modifying antirheumatic drugs (DMARDs) (Methotrexate and Ketoprofen) on glomerular and tubular integrity in patients with Rheumatoid arthritis (RA).


OBJECTIVE



OBJECTIVE
To determine whether there is a change in clinical and laboratory indicators of renal function in course of the follow up of treatment and whether that change correlates with the dynamics of the quantity of enzymes excreted in urine and reactants of the acute phase.


METHODS
Using colorimetric method for determination of NAG, samples of 70 participants were examined (35 RA patients treated with Ketoprofen only, 35 RA patients treated with combined use of Methotrexate and Ketoprofen). The follow up was 5 time-intervals in the course of 24 weeks.


RESULTS
There was moderate correlation between NAG and microalbuminuria (r=0,34) in the group of patients treated with Ketoprofen only, while statistically significant correlation (r=0,21) was seen in group of patients with combined use of Methotrexate and Ketoprofen. NAG enzymuria in size, number of patients registered, and time of appearance were greater and appears earlier in the group with the combined use of Methotrexate and Ketoprofen compared with the mono-therapy with Ketoprofen. Mean urinary NAG induction was increasing with the concomitant use of Methotrexate and Ketoprofen.


CONCLUSIONS
Methotrexate is more potent NAG inductor than Ketoprofen and provokes greater tubular enzymuria than Ketoprofen.
Department of Rheumatology.
Dejan
D
Spasovski
Department of Hematology.
Arif
A
Latifi
Department of Rheumatology.
Nada
N
Marina
Department of Rheumatology.
Jordan
J
Calovski
Department of Rheumatology.
Irena
I
Kafedziska
Department of Rheumatology.
Gjorgi
G
Božinovski
Department of Rheumatology.
Snežana
S
Percinkova
Department of Preclinic Farmacology.
Maja
M
Slaninka-Micevska
Department of Preclinic Farmacology.
Trajan
T
Balkanov
Department of Physiology.
Beti
B
Dejanova
Institutes of preclinical biochemistry.
Sonja
S
Alabakovska
Department of Hematology.
Svetlana
S
Krstevska-Balkanov
Department of Nephrology.
Goce
G
Spasovski
Department of Rheumatology, University Clinical Centre, Skopje, Republic of Macedonia.
Dejan
D
Spasovski
Immunosuppressive drugs; N-acetyl-D-glucosaminidase; Rheumatoid arthritis; Symmetric dimethyl arginine