Disease activity of rheumatoid arthritis and kidney function decline: a large prospective registry study
Authors' conclusion
Higher RA disease activity was associated with accelerated eGFR decline and increased risk of clinically relevant kidney dysfunction.
Study context
- Population
- Patients with rheumatoid arthritis (RA) in a multicentre prospective registry, USA, 2001–2022 (median age 58.0 years; female 76.3%; median estimated glomerular filtration rate (eGFR) 90.7 mL/min/1.73 m²)
- Participants
- 31,129 patients146,778 person-years
- Exposure
- Updated time-averaged Clinical Disease Activity Index (TA-CDAI) categories: low, moderate and high disease activity vs remission
- Outcome
- Longitudinal eGFR change
Methodological detailsmulticentre, prospective registry, multivariable mixed-effect linear model, adjusted for time-fixed and time-varying covariates
- Multicentre
- Prospective registry
- Multivariable mixed-effect linear model
- Adjusted for time-fixed and time-varying covariates
Main finding
As reported in the abstract
Annual eGFR decline · during follow-up
Estimated additional annual decline
−0.09 mL/min/1.73 m²
95% CI −0.15 to −0.03
Low
Estimated additional annual decline
−0.17 mL/min/1.73 m²
95% CI −0.23 to −0.10
Moderate
Estimated additional annual decline
−0.18 mL/min/1.73 m²
95% CI −0.27 to −0.08
High
TA-CDAI remission
−0.83
average · mL/min/1.73 m²
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | |
|---|---|---|
| CKD stage G3a (eGFR<60 mL/min/1.73 m²) · during follow-upLowvs TA-CDAI remission | 1.15 (1.01–1.30) | |
| CKD stage G3a (eGFR<60 mL/min/1.73 m²) · during follow-upModeratevs TA-CDAI remission | 1.22 (1.06–1.40) | |
| CKD stage G3a (eGFR<60 mL/min/1.73 m²) · during follow-upHighvs TA-CDAI remission | 1.27 (1.05–1.52) | |
| CKD stage G3b (eGFR<45 mL/min/1.73 m²) · during follow-upLowvs TA-CDAI remission | 1.22 (0.84–1.76) | |
| CKD stage G3b (eGFR<45 mL/min/1.73 m²) · during follow-upModeratevs TA-CDAI remission | 1.66 (1.12–2.45) | |
| CKD stage G3b (eGFR<45 mL/min/1.73 m²) · during follow-upHighvs TA-CDAI remission | 1.93 (1.16–3.20) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Original publication
Disease activity of rheumatoid arthritis and kidney function decline: a large prospective registry study. Ann Rheum Dis. Published 2 January 2025. doi:10.
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