药物治疗类风湿性关节炎会引起肾功能损害
【摘要】类风湿性关节炎患者在服用药物治疗后，会引起体内血肌酐浓度的增高以及蛋白尿的出现，从而提示有肾功能损害。【全文】Arthritis Medications Associated With Renal DiseaseA DGReview of :"A prospective study of renal disease in patients with early rheumatoid arthritis"Annals of the Rheumatic Diseases03/26/2001By David LoshakA raised serum creatinine concentration or persistent proteinuria in patients with early rheumatoid arthritis is predominantly drug related.By contrast, isolated haematuria is more directly associated with the activity of the disease process.Researchers at Tokyo Women's Medical University, Japan, ran a prospective study to clarify the frequency, causes and clinical course of renal disease in patients with rheumatoid arthritis of less than one year's duration. The researchers enrolled 235 patients, including 185 women of mean age 49.4 years, who were assessed monthly for an average of 42 months. Proteinuria was defined as a positive dipstick result. Microscopic haematuria was defined as the presence of five red blood cells per high power field. Urinary abnormalities lasting three months or longer were defined as persistent abnormalities.At entry, 40 patients exhibited haematuria and two had a raised serum creatinine concentration, but none had proteinuria. Persistent haematuria was found in 43 patients, persistent proteinuria in 17 patients and raised serum creatinine concentration in 14 patients. Persistent proteinuria was caused by drugs in 14 of 17 patients and disappeared in most cases. Risk factors for drug-induced proteinuria included raised C reactive protein, raised erythrocyte sedimentation rate and age over 50 years at entry. Drugs resulted in a raised serum creatinine concentration in eight of 14 patients. The incidence of haematuria at entry did not differ among patients who had been treated with non-steroidal anti-inflammatory drugs or disease modifying anti-rheumatic drugs or who had not received any drug treatment. In some patients with isolated haematuria, the haematuria appeared when rheumatoid arthritis activity was high and resolved when it was low., 百拇医药