Microalbuminuria: A marker of severe disease activity in rheumatoid arthritis

ObjectiveMicroalbuminuria is associated with increased risk for renal and cardiovascular mortality and morbidity in diabetes mellitus, hypertension, patients with acute myocardial infarction and elderly patients but the significance of microalbuminuria in rheumatoid arthritis and its correlation with disease activity is not well studied. The present study is therefore aimed to determine the microalbuminuria in rheumatoid arthritis patients and to correlate it with indicators of disease activity like CRP and ESR.MethodsHundred confirmed cases of Rheumatoid arthritis (2010 ACR-EULAR criteria) and hundred age and sex matched controls were taken. Those suffering from hypertension, diabetes mellitus and renal disease were excluded. Microalbumin was assessed by immunoturbidimetric method on Delta nephelometer. Disease activity was assessed by CRP and ESR.ResultsThe relative frequency of microalbuminuria in patients with rheumatoid arthritis was 26% as compared to 4% in controls. The median level of microalbuminuria in rheumatoid arthritis patients was significantly greater than in the controls (17 vs. 3.29, p < 0.01). Microalbuminuria significantly correlated with CRP (p < 0.001, r = 0.457) and ESR (p < 0.001, r = 0.361). A significant correlation was found with duration of disease (p < 0.05, r = 0.231) and number of joints involved (p < 0.05, r = 0.240).ConclusionsWe found increased prevalence of microalbuminuria in rheumatoid arthritis patients and it correlated with acute phase reactants.