Rheumatoid arthritis (RA) is a type of inflammatory disease that typically involves the joint spaces between the small bones in the hands. The lining of the joints is attacked by the body’s own immune system. These joints become red, painful, and swollen. Over time, the bones can erode and cause the fingers to become twisted or deformed.
As the disease progresses, more joints can become affected, including the hips, shoulders, elbows, knees, and even the spaces between the vertebrae in the spine. If left untreated, inflammation may also begin to damage major organs in the body. Most commonly affected are the skin, eyes, heart, blood vessels, lungs and kidneys.
Inflammation due to RA has long been thought to affect kidney function. Inflammation is the body’s way of protecting itself when there’s something wrong, like illness or injury. The inflammation helps to heal injured or diseased tissue. But over time, chronic inflammation takes its toll on the whole body, causing stress and damaging or destroying cells and tissues.
Research indicates that those with RA are more likely to have kidney disease. As many as one in four people develop reduced kidney function over the long term. Newer studies show that a combination of risk factors, along with RA, may be to blame. A recent study by the Mayo Clinic lists several factors that can contribute to kidney disease in patients with RA. These include:
- higher levels of inflammation within the first year of diagnosis
- high blood pressure
- use of corticosteroid medications, like prednisone or cortisone
- high cholesterol
- high-salt diet
- chronic use of non-steroidal anti-inflammatory medications
While RA may not necessarily cause kidney disease, kidney problems are more likely to develop if other conditions are also making the kidneys work harder.
One of best things you can do to protect yourself from RA-related kidney disease is to control the inflammation. Your doctor will probably put you on prescription drugs known as DMARDs, or disease-modifying anti-rheumatic drugs. DMARDs work to control the inflammation of RA. You may also take over-the-counter anti-inflammatory drugs like ibuprofen or naproxen.
Your doctor should also monitor you regularly for kidney problems. Routine blood or urine tests can be conducted to make sure your kidneys are working properly. Testing should be done at least once a year, based on your overall health and your doctor’s recommendations.
For the other risk factors, you and your doctor need to work together to reduce your risk of kidney disease. Talk to your healthcare provider about:
- the benefits and risks of corticosteroid drugs
- losing weight or maintaining a healthy weight
- adopting a low-sodium diet
- monitoring your blood pressure and finding ways to keep it under control
- keeping tabs on your cholesterol levels, and any medication or dietary changes that may be necessary
Exercise is the one thing that can help with nearly all of these factors. Regular, gentle exercise can ease inflammation, control your weight, and lower blood pressure. The important thing is to not overdo it. Make your activity low-impact or nonimpact, and rest when necessary. Your doctor or physical therapist can help you create a good exercise regimen that’s easy on your joints.
RA is a chronic disease, and if not managed properly, it can lead to other health problems. Fortunately, kidney disease doesn’t have to be one of them. A few simple lifestyle changes and a watchful eye can make all the difference.