Clinical and Biochemical Correlation of Microalbuminuria in Rheumatoid Arthritis Patients

Objective: There are very few well-known studies regarding the significance of microalbuminuria in Rheumatoid arthritis patients and its clinical and biochemical correlations with disease activity. The present study is therefore aimed to determine the presence of microalbuminuria in Rheumatoid arthritis patients and to correlate with different parameters of disease activity.

Methods: This Cross-sectional observational study was conducted on purposively selected patients who attended Department of Medicine, Mymensingh Medical College Hospital, Mymensingh during the period from April, 2017 to March, 2018. 110 cases with Rheumatoid Arthritis (RA) meeting the exclusion and inclusion criteria were interviewed, examined and investigated to find out correlation of clinical and biochemical parameters of disease activity with presence of microalbuminuria in Rheumatoid arthritis patients.

Results: Out of 110 RA patients, 30 (27.3%) were male and 80 (72.7%) were female with a mean age of patients (42.94 ± 4.87) years in microalbuminuria positive group and (39.48 ± 6.19) years in microalbuminuria negative group. 33(30%) cases (25 female and 8 male) had microalbuminuria positive. Duration of morning stiffness was significantly longer in patients with microalbuminuria positive. Out of 33 patients positive for microalbuminuria, 27 patients had morning stiffness lasting more than 60 min. Mean number of joints involved was 18.12 ± 3.21 in microalbuminuria positive group (P<0.001). Mean ESR in microalbuminuria positive patients was 88.00 ± 23.14 mm in 1st hour (P<0.001). Mean CRP in microalbuminuria positive patients was 42.90 ± 12.01mg/l (P<0.001). Disease Activity Score (DAS) is higher in microalbuminuria positive patients (4.92±1.18) than negative patients (3.36±1.06) which is statistically significant (p<0.001).Among 33 microalbuminuria positive patients,18 patients had evidence of joint erosion on X ray(P<0.001).

Conclusion: RA patients having microalbuminuria were found significant clinical and biochemical correlation with severe disease activity. Microalbuminuria may be routinely measured in all Rheumatoid arthritis patients to detect renal involvement in an incipient stage to minimize disease morbidity.