Prevalence of microalbuminuria and its association with disease activity, inflammatory markers, and disease-modifying anti-rheumatoid drugs in rheumatoid arthritis
M. S. Nithin, Vinay R. Pandit, Jhasaketan Meher, Joydeep Samanta, Rohini RokkamObjectives:
Urinary protein or albumin can be an early laboratory modality to diagnose nephropathy early in rheumatoid arthritis (RA). Therefore, our objective was to estimate the prevalence of microalbuminuria in RA and to find any association with disease activity and other parameters.
Materials and Methods:
We conducted this cross-sectional study from 2022–2023. It included 75 RA patients aged ≥18 years. Urine albumin-to-creatinine ratio (ACR) was measured in all participants. All clinical and laboratory parameters were recorded. Disease activity was measured by the disease activity score-28 erythrocyte sedimentation rate (ESR).
Statistical analysis:
Appropriate statistical tests were used by the Statistical Package for the Social Sciences version 22. Pearson’s correlation was used to determine the correlation between microalbuminuria and disease activity and other factors.
Results:
The mean age of participants was 45.70 ± 11.43 years. The majority of participants had moderate to high disease activity (81.3%). Microalbuminuria was seen in 13.3%, whereas 9.3% participants had macroalbuminuria. Microalbuminuria correlated significantly with disease activity ( p = 0.032) and C-reactive protein (CRP) ( p = 0.004) but not with ESR ( p = 0.197). Furthermore, albuminuria correlated significantly with the duration of disease (r = 0.87, p = 0.011). Microalbuminuria was less common in those who were on combination disease-modifying anti-rheumatoid drugs (DMARDs) ( p = 0.045).
Conclusions:
The prevalence of microalbuminuria and macroalbuminuria was high in the Indian cohort. Furthermore, a higher degree of microalbuminuria correlated with disease severity and longer duration of disease. However, a lower incidence of albuminuria was associated with the use of a combination of conventional DMARDs. Therefore, emphasis should be placed on periodically monitoring the urine ACR, especially in advanced active disease.