Impact of concomitant chronic kidney disease on hospitalised infections and remission in patients with rheumatoid arthritis: results from the IORRA cohort
Impact of concomitant chronic kidney disease on hospitalised infections and remission in patients with rheumatoid arthritis: results from the IORRA cohort
复制标题
并发慢性肾脏病对类风湿关节炎患者住院感染和缓解的影响：来自 IORRA 队列的结果
DOI：
10.1093/mr/roab082
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发表时间：
2021
影响因子：
2.2
通讯作者：
Harigai Masayoshi
中科院分区：
文献类型：
--
作者：
Higuchi Tomoaki;Tanaka Eiichi;Inoue Eisuke;Abe Mai;Saka Kumiko;Sugano Eri;Sugitani Naohiro;Higuchi Yoko;Ochiai Moeko;Yamaguchi Rei;Sugimoto Naoki;Ikari Katsunori;Yamanaka Hisashi;Harigai Masayoshi
ObjectivesTo探讨伴随慢性肾脏疾病（CKD）对日本类风湿性关节炎（RA）患者不利的临床事件和缓解的影响。MethodsWe纳入了5103例来自风湿性关节炎研究所（IORRA）队列的RA和CKD患者。CKD分期分为4组：正常eGFR ≥60 ml/min/1.73 m2伴蛋白尿的CKD;轻度CKD，eGFR ≥45至< 60;中度CKD，eGFR ≥30至< 45;重度CKD，eGFR <30。我们评估了伴随CKD和不利的临床事件的发生或实现缓解在5年的观察period.ResultsOf 5103例RA患者，686（86.6%）有CKD之间的关联。合并CKD与住院感染相关[校正风险比（aHR）1.52，95%置信区间（CI）1.07- 2.13，p = .02]，尤其是在中度至重度CKD组（aHR 1.93，95% CI 1.12- 3.13，p = .02）。在所有受试者中，2407例（47.2%）在基线时患有活动性RA，401例（16.7%）患有CKD。伴随CKD也与未能达到缓解相关（aHR 0.82，95%CI 0.68- 0.99，p = 0.04）。结论伴随CKD是日本RA患者住院感染和活动性RA患者未能达到缓解的危险因素。
ObjectivesTo investigate the impact of concomitant chronic kidney disease (CKD) on unfavourable clinical events and remission in Japanese patients with rheumatoid arthritis (RA).MethodsWe included 5103 patients with RA and CKD from the Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort in 2012. CKD stages were classified into four groups: CKD with normal eGFR ≥60 ml/min/1.73 m2and proteinuria; mild CKD, eGFR ≥45 to < 60; moderate CKD, eGFR ≥30 to < 45; and severe CKD, eGFR <30. We assessed the association between concomitant CKD and the occurrence of unfavourable clinical events or achieving remission during a 5-year observational period.ResultsOf the 5103 patients with RA, 686 (86.6%) had CKD. Concomitant CKD was associated with hospitalised infections [adjusted hazard ratio (aHR) 1.52, 95% confidence interval (CI) 1.07–2.13,p= .02], especially in the moderate to severe CKD group (aHR 1.93, 95% CI 1.12–3.13,p= .02). Of all subjects, 2407 (47.2%) had active RA at baseline and 401 (16.7%) had CKD. Concomitant CKD was also associated with the failure of achieving remission (aHR 0.82, 95% CI 0.68–0.99,p= .04).ConclusionsConcomitant CKD was a risk factor for hospitalised infections in Japanese patients with RA and failure of achieving remission in patients with active RA.