title: Prevalence of Renal Impairment in Patients With Rheumatoid Arthritis: Results From a Cross-Sectional Multicenter Study.
abstract: To assess the prevalence and associations of renal dysfunction in patients with rheumatoid arthritis (RA).
  
  
  
  COMEDRA is a French nationwide cross-sectional multicenter study on comorbidities in RA. Renal function was assessed from the estimated glomerular filtration rate (eGFR), using the Modification of Diet in Renal Disease equation. RA characteristics and risk factors for renal impairment were collected. Two logistic regression models, 1 with and 1 without the Framingham Risk Score, were constructed from variables that were significantly associated with an eGFR of <60 ml/minute/1.73 m(2) or were clinically relevant.
  
  
  
  Of the 970 recruited patients, 931 were analyzed (women 79.6%, mean age 57.8 years, disease duration 11.1 years, Disease Activity Score in 28 joints using the erythrocyte sedimentation rate [DAS28-ESR] 3.1). A total of 82 patients (8.8%) had an eGFR <60 ml/minute/1.73 m(2) and 9% had proteinuria. In univariate analysis, renal impairment was associated with age (P < 0.001), history of hypertension (P < 0.001), high systolic blood pressure (P = 0.03), and the Systematic Coronary Risk Evaluation (SCORE) equation (P = 0.002), but not with sex, disease duration, disease activity (as assessed by DAS28-ESR), nonsteroidal antiinflammatory drug use, disease severity (erosions, joint replacement), or RA medications. Multivariate analysis models showed that age (odds ratio [OR] 1.05 [95% confidence interval (95% CI) 1.03-1.09]) and hypertension (OR 2.5 [95% CI 1.5-4.3]) were associated with renal impairment. A second model showed that the SCORE equation (OR 1.33 [95% CI 1.06-1.67]) was associated with renal impairment.
  
  
  
  Renal impairment is relatively common in RA and is associated with cardiovascular risk factors such as age, hypertension, and the SCORE equation but not with disease activity or severity.
authors: Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Marion
authors: M
authors: Couderc
authors: Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Zuzana
authors: Z
authors: Tatar
authors: Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Bruno
authors: B
authors: Pereira
authors: Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Aurélien
authors: A
authors: Tiple
authors: Sud University Hospital, Grenoble, France.
authors: Mélanie
authors: M
authors: Gilson
authors: Pitié-Salpêtrière Hospital, Assistance Publique, Hôpitaux de Paris, Paris, France.
authors: Bruno
authors: B
authors: Fautrel
authors: Bois-Guillaume Hospital, Rouen, France.
authors: Sophie
authors: S
authors: Pouplin
authors: Le Mans Hospital, Le Mans, France.
authors: Emmanuelle
authors: E
authors: Dernis
authors: Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, and Pitié Salpêtrière Hospital, Assistance Publique, Hôpitaux de Paris, Paris, France.
authors: Laure
authors: L
authors: Gossec
authors: Nîmes University Hospital, Nîmes, France.
authors: Cécile
authors: C
authors: Gaujoux-Viala
authors: Gabriel Montpied University Hospital, Clermont-Ferrand, France.
authors: Martin
authors: M
authors: Soubrier
authors: PRES Sorbonne Paris-Cité, Paris, France.
authors: Maxime
authors: M
authors: Dougados
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology*; D001799:Blood Sedimentation; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007674:Kidney Diseases / Q000150:complications / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index