Vital Annex: International Journal of Novel Research in Advanced Sciences (ijnras)

Vital Annex: International Journal of Novel Research in Advanced Sciences 
(IJNRAS) 
Volume: 01 Issue: 05 | 2022 ISSN: 2751-756X  
http://innosci.org 
 
397 | Page 
nephrons, with an outcome in chronic renal failure, with an extremely unfavorable prognosis, which 
determines the importance of early diagnosis and treatment of nephropathies in RA. Renal 
pathology is detected with RA with a high frequency - about 60%, according to different authors 
[36]. 
The course of rheumatoid nephropathy, as well as other chronic kidney diseases, is progressive in 
nature with the development of nephrosclerosis and a decrease in the foothold of functioning 
nephrons, with an outcome in chronic renal failure, with an extremely unfavorable prognosis, which 
determines the importance of early diagnosis and treatment of nephropathies in RA. Renal 
pathology is detected with RA with a high frequency - about 60%, according to different authors 
[36]. 
In patients with RA, various renal diseases can occur: secondary amyloidosis of the kidneys, 
glomerulonephritis, interstitial nephritis, vasculitis of the renal vessels, nephrosclerosis, and in some 
cases their combination [30,37]. Etiologically, very conditionally, kidney damage in RA patients 
can be divided into 2 groups: firstly, nephropathy as one of the extra-articular manifestations or 
complications of RA itself, for example, renal vascular vasculitis, chronic glomerulonephritis, 
secondary amyloidosis, and secondly, as a complication of drug therapy R A: analgesic 
nephropathy (AN), drug-induced glomerulonephritis. 
The pathogenesis of such different renal diseases cannot be the same. Vasculitis of the renal vessels 
and glomerulonephritis are of an immune nature, mainly immunocomplex; in severe cases, signs of 
an autoimmune process are recorded. The toxic effects of long-term use of NSAIDs on the enzyme 
systems of renal tubular epithelial cells and interstitium underlie the development of AN. A certain 
contribution to the progression of chronic kidney disease is made by disturbances in the hemostasis 
system, endothelial dysfunction [41,43,24], the frequency of exacerbations of the disease, the 
presence of crescents and the severity of tubulointerstitial changes in the nephrobioptate [21]. 
Patients with rheumatoid vasculitis of the renal vessels are more likely to have a mild transient 
decrease in renal function along with transient hematuria suggestive of local inflammation, and 
severe renal failure is rare [38,1]. The spectrum of renal pathology underlying CKD in RA is quite 
wide. Secondary amyloidosis for many years occupied the main position among the variants of 
nephropathy in patients with RA [45,28]. According to some studies, there is a tendency to change 
the structure of kidney damage in RA [6]. 
Many researchers have noted that the development of CKD and the severity of its manifestations in 
RA patients are determined by the duration and activity of the underlying disease, age, the presence 
of arterial hypertension (AH), lipid metabolism disorders and hyperglycemia [46, 2, 17].The 
unfavorable prognostic significance of kidney damage in rheumatoid arthritis (RA) has been 
actively attracting the attention of researchers in recent years [10].Certain clinical variants of kidney 
involvement in the pathological process in rheumatoid arthritis are observed in most patients [33]. 
Various variants of kidney damage in rheumatoid arthritis have been described, in particular, 
glomerulonephritis, amyloidosis, vasculitis, as well as iatrogenic forms (analgesic tubulopathies, 
membranous nephropathy, etc.) [35,29,32]. It is noteworthy that in real clinical conditions in such 
patients, morphological verification of renal pathology may not be performed for a long time for a 
number of objective reasons. Early manifestations of functional renal disorders, especially when 
they are moderate, do not always attract the attention of clinicians, while the progression of chronic 
kidney disease (CKD) in RA can be rapid, especially in old age, as well as in association with 
cardiovascular disease. pathology [11,14].According to some researchers, the development of CKD 
in RA may be associated with cardiovascular damage to a greater extent than with the activity of 
RA itself [16]. 

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