This comparative cross-sectional study aims to determine the prevalence of subclinical renal dysfunction in patients with rheumatoid arthritis and to evaluate its association with disease activity and inflammatory markers compared with age- and sex-matched healthy controls at Assiut University Hospitals.
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that may be associated with early renal involvement even before overt chronic kidney disease develops. Subclinical renal dysfunction refers to early impairment of renal function that is not detected by conventional serum creatinine alone. This hospital-based comparative cross-sectional study will include two groups: patients with rheumatoid arthritis diagnosed according to the 2010 ACR/EULAR classification criteria, and age- and sex-matched apparently healthy controls. All participants will undergo clinical assessment, disease activity evaluation using DAS28, laboratory investigations including estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR), and renal ultrasonography. The study will determine the prevalence of subclinical renal dysfunction and assess its association with disease activity, inflammatory markers, serological markers, disease duration, and treatment-related factors.
Study Type
OBSERVATIONAL
Enrollment
120
Prevalence of subclinical renal dysfunction
Proportion of participants with subclinical renal dysfunction, defined as the presence of reduced estimated glomerular filtration rate (eGFR \< 90 mL/min/1.73 m²) and/or elevated urine albumin-to-creatinine ratio (UACR ≥ 30 mg/g) in the absence of previously diagnosed chronic kidney disease.
Time frame: Baseline
Comparison of eGFR between groups
Mean difference in estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation between rheumatoid arthritis patients and healthy controls.
Time frame: Baseline
Comparison of UACR between groups
Difference in urine albumin-to-creatinine ratio (mg/g) between rheumatoid arthritis patients and healthy controls.
Time frame: Baseline
Correlation of subclinical renal dysfunction with disease activity
Correlation coefficient between the presence of subclinical renal dysfunction and DAS28-ESR score (and DAS28-CRP), using Spearman or Pearson correlation as appropriate.
Time frame: Baseline
Correlation of subclinical renal dysfunction with inflammatory markers
Correlation coefficient between the presence of subclinical renal dysfunction and levels of erythrocyte sedimentation rate (ESR, mm/h) and C-reactive protein (CRP, mg/L), using Spearman or Pearson correlation as appropriate..
Time frame: Baseline
Independent predictors of subclinical renal dysfunction
Odds ratios of clinical, inflammatory, serological, disease-related, and treatment-related factors for the presence of subclinical renal dysfunction using multivariable logistic regression analysis.
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Time frame: Baseline