Table 3. Association between RA disease characteristics and reduced kidney function in patients with RA.
| eGFR <60* | eGFR <45** | |||
|---|---|---|---|---|
| HR (95% CI) | p | HR (95% CI) | p | |
| RA characteristic | ||||
| ESR at index (per 10-mm/h greater) | 1.05 (0.96, 1.15) | 0.3 | 1.07 (0.93, 1.25) | 0.4 |
| Highest ESR in 1st y (per 10-mm/h greater) | 1.08 (1.00, 1.16) | 0.05 | 1.14 (1.02, 1.26) | 0.02 |
| RF positiveˆ | 0.80 (0.55, 1.16) | 0.2 | 0.95 (0.52, 1.74) | 0.9 |
| Current smokerˆˆ | 1.13 (0.71, 1.79) | 0.6 | 1.70 (0.86, 3.39) | 0.1 |
| Former smokerˆˆ | 1.05 (0.70, 1.57) | 0.8 | 0.74 (0.37, 1.50) | 0.4 |
| Time-dependent characteristic# | ||||
| Hypertension | 2.05 (0.81, 5.17) | 0.1 | 3.12 (0.41, 23.78) | 0.3 |
| Diabetes Mellitus | 1.51 (0.97, 2.36) | 0.07 | 1.59 (0.82, 3.09) | 0.2 |
| Dyslipidemia | 1.99 (1.17, 3.37) | 0.01 | 1.74 (0.76, 3.99) | 0.2 |
| CVD | 1.77 (1.14, 2.73) | 0.01 | 3.62 (1.92, 6.82) | <0.001 |
| BMI Category | ||||
| ≥30 kg/m2 | 1.87 (1.28, 2.73) | 0.001 | 1.75 (0.96, 3.17) | 0.07 |
| <20 kg/m2 | 0.51 (0.29, 0.90) | 0.02 | 0.77 (0.35, 1.70) | 0.5 |
| Nodules | 1.06 (0.69, 1.64) | 0.8 | 1.16 (0.60, 2.24) | 0.7 |
| Erosions/destructive changes on radiographs | 0.94 (0.64, 1.36) | 0.7 | 1.53 (0.84, 2.80) | 0.2 |
| Severe extra-articular manifestations | 1.06 (0.55, 2.04) | 0.9 | 2.25 (1.06, 4.77) | 0.04 |
| Large joint swelling | 1.06 (0.69, 1.65) | 0.8 | 1.67 (0.74, 3.79) | 0.2 |
| Joint surgery | 0.93 (0.61, 1.43) | 0.7 | 1.46 (0.78, 2.71) | 0.2 |
| MTX | 1.22 (0.82, 1.79) | 0.3 | 1.13 (0.60, 2.14) | 0.7 |
| HCQ | 0.82 (0.56, 1.21) | 0.3 | 1.03 (0.56, 1.89) | 0.9 |
| Other DMARD | 1.01 (0.64, 1.57) | 0.9 | 0.91 (0.45, 1.86) | 0.8 |
| Biologic | 0.46 (0.14, 1.45) | 0.2 | 1.82 (0.53, 6.25) | 0.3 |
| Steroids | 1.49 (0.96, 2.31) | 0.08 | 2.49 (1.18, 5.23) | 0.02 |
| NSAID | 0.59 (0.35, 0.98) | 0.04 | 1.84 (0.56, 6.10) | 0.3 |
| COX-2 | 0.92 (0.60, 1.41) | 0.7 | 0.78 (0.38, 1.59) | 0.5 |
Note: Systemic glucocorticoids included either oral or intravenous forms (e.g., prednisone, methylprednisolone, hydrocortisone, dexamethasone). Other DMARDs included sulfasalazine, leflunomide, and azathioprine. Biologic included tumor necrosis factor inhibitors, anakinra, abatacept, and rituximab.
ESR: erythrocyte sedimentation rate; RF: rheumatoid factor; CVD: cardiovascular disease; BMI: body mass index; MTX: methotrexate; HCQ: hydroxychloroquine; DMARD: disease-modifying antirheumatic drugs; NSAID: nonsteroidal anti-inflammatory drugs; COX-2: cyclooxygenase 2 inhibitor. eGFR, estimated glomerular filtration rate; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; RA, rheumatoid arthritis
eGFR <60 was defined as two consecutive eGFR <60 mL/min/1.73 m2 at least 90 days apart using the CKD-EPI creatinine equation.
eGFR <45 was defined as two consecutive eGFR <45 mL/min/1.73 m2 at least 90 days apart using the CKD-EPI creatinine equation.
Reference: RF negative
Reference: nonsmokers
Reference: patients without each characteristic