Impaired renal functions in Pakistani cohort of rheumatoid arthritis

Wagan, Abrar Ahmed; Nasir, Sadia; Rahim, Abdul; Khan, Daim

doi:10.12669/pjms.35.4.564

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…7 Hypertension, smoking and self-use NSAIDS/ Hakeem medication lead to impaired renal function in RA patients. 8 Initiating treatment within 12 weeks of symptoms onset (therapeutic window of opportunity) 9 doubles the chances of achieving remission and decreases necessity of using biologics in RA treatment from 32.24% to 10% 10,11 leading to better functional outcome (lower HAQ-DI values) with good radiographic outcome and lower disease progression rate. 9,12 Main objective of this study was to identify factors contributing to diagnostic and therapeutic delay in RA patients and to evaluate relationship of diagnostic and therapeutic delay with disease outcome, previously never studied in Pakistan.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic and therapeutic delay in Rheumatoid Arthritis patients: Impact on disease outcome

Naeem

Khan

Saeed³

et al. 2021

Pak J Med Sci

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Objective: To identify factors causing diagnostic and therapeutic delay in patients with rheumatoid arthritis, and to evaluate relationship of diagnostic and therapeutic delay with disease outcome. Methods: This cross-sectional study was conducted in Rheumatology Department, Fatima Memorial Hospital, Lahore, Pakistan, from May 2018 to July 2018. In this study 102 patients fulfilling ACR/EULAR criteria 2010 were enrolled. Lag times were calculated in months: lag-1 (delay in initial medical consultation); lag-2 (delay in consulting rheumatologists); lag-3 (diagnostic delay); lag-4 (therapeutic delay). Disease activity and functional outcome were measured by DAS28, HAQ-DI respectively. Association of lag-3 and lag-4 with HAQ-DI and DAS28 was calculated by Pearson correlation. Results: Median (IQR) disease duration of study group was 6(2-10) years. Initial consultations were with; orthopedic surgeon 40(39.2%), general practitioner 27(26.5%), rheumatologist 13(12.7%), medical specialists 14(13.7%). Median (IQR) lag times in months: lag-1 (delayed initial consultation): 2(0-5), lag-2 (delay in consulting rheumatologist): 30(7.7-72), lag-3 (diagnostic delay): 12(3-48), lag-4 (therapeutic delay):18(5.7-72). Factors attributed to lag-3 (diagnostic delay) and lag-4 (therapeutic delay) (p<0.05): older Age (r= 0.2), education level (r= - 0.2), initial consultation (non-rheumatologist) (r=0.2), lag-2(r=0.8), >three doctors visited before diagnosis(r=0.6). Positive anti-CCP antibodies(r=0.2) and lag-1 (delayed initial consultation) (r=1) were associated with lag-3 (diagnostic delay) only; no association was found with positive RA factor. Significant correlation (p=<0.05) of lag-3 (diagnostic delay) was found with both DAS28(r=0.2) & HAQ-DI(r=0.2). Similarly lag-4 (therapeutic delay) also correlated with both & DAS28(r=0.2) & HAQ-DI(r=0.3) (p=<0.05). Conclusion: Diagnostic and therapeutic delay were associated with older age, lower education and delayed consultation with rheumatologist but not with positive RA factor. Positive anti-CCP antibodies were associated with diagnostic delay only. Diagnostic and therapeutic delay led to high disease activity and poor functional outcome in RA patients. doi: https://doi.org/10.12669/pjms.37.4.3471 How to cite this:Naeem F, Khan SEA, Saeed MA, Farman S. Diagnostic and therapeutic delay in Rheumatoid Arthritis patients: Impact on disease outcome. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3471 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

“… 7 Hypertension, smoking and self-use NSAIDS/Hakeem medication lead to impaired renal function in RA patients. 8 …”

Section: Introductionmentioning

confidence: 99%

Diagnostic and therapeutic delay in Rheumatoid Arthritis patients: Impact on disease outcome

Naeem

Khan

Saeed³

et al. 2021

Pak J Med Sci

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“…The use of contrast-enhanced MRI is limited in patients with AS because of the frequent association of AS with glomerulopathies. 9 MT and DWI technologies can be used to quantitatively determine AS activity without a contrast agent. Ostrowska et al 10 Observed that BME represents an important indicator of bone destruction and could reflect inflammatory activity.…”

Section: Discussionmentioning

confidence: 99%

Differentiating active from Inactive Sacroiliitis in ankylosing spondylitis by combination of DWI and Magnetization Transfer Imaging

Ning¹,

Fan²,

Ren³

et al. 2023

Pak J Med Sci

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Objectives: To evaluate lesions of sacroiliac joint (SIJ) by combination of diffusion-weighted imaging (DWI) and magnetization transfer (MT). Methods: A retrospective study was used in this study. Forty-nine ankylosing spondylitis (AS) patients admitted to The China Academy of Chinese Medical Sciences Xiyuan Hospital from May 2020 to October 2020 were collected into active and inactive groups. Twenty-two healthy volunteers were recruited. Apparent diffusion coefficient (ADC) values for bone marrow edema (BME), sclerosis area, fat deposit area, and normal-appearing bone marrow (NABM) (both patients and healthy volunteers) and the magnetization transfer (MT) rate of the cartilage (MTRc) were analyzed in the groups. The above five parameters (ADC (NABM), ADC (BME) and ADC (fat deposit) and MTRc) between the active group and the inactive group were compared. The effectiveness of each parameter in diagnosing sacroiliac arthritis of ankylosing spondylitis were analyzed, and the predictive value of the parameters was compared. Results: ADC(BME), ADC(NABM) and MTRc showed statistically significant differences between the active and inactive groups (P <0.05). ADC (BME) and ADC (NABM) could predict the activity of AS sacroiliac arthritis (P <0.01). ADC (NABM) and MTRc were significantly different between healthy volunteers and the active group (P <0.01). The areas under the ROC curve (AUCs) of ADC (BME)_ADC(NABM), ADC(NABM)_MTR, and ADC(BME)_MTRc were 0.885 (cut-off value=0.69), 0.849 (cut-off value=0.56) and 0.864 (cut-off value=0.60), respectively. The predictive ability of the combined index ADC (BME)_MTRc and ADC(NABM)_MTRc was increased. Conclusion: The ability to diagnose and predict AS might be improved by the combination of diffusion-weighted imaging (DWI) and magnetization transfer (MT). doi: https://doi.org/10.12669/pjms.39.2.6094 How to cite this: Ning Q, Fan T, Ren H, Ye H, Wang W. Differentiating active from Inactive Sacroiliitis in ankylosing spondylitis by combination of DWI and Magnetization Transfer Imaging. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6094 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…4 One of the reasons for unsuccessful control of hypertension is long term use of NSAIDS in coexisting conditions like arthritis and gout. 5 NSAIDs are commonly used in Pakistan as analgesic, antiinflammatory and anti-pyretic agents. They also have many side effects such as exacerbation of asthma symptoms, increased bleeding tendency and gastric and duodenal ulceration.…”

Section: Introductionmentioning

confidence: 99%

Comparative Evaluation of Aloe vera and Diclofenac on Body Weight, Blood Pressure and Renal Function of Hypertensive Rats

Yaqoob

2021

Proceedings S.Z.M.C

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Introduction: NSAIDs are known to cause salt and water retention leading to hypertension and renal impairment. Aloe vera gel has been used in medicinal preparations for decades. Limited data is available regarding effect of Aloe vera on renal function. There is a need to search this aspect of Aloe vera, to use it judiciously. Aims & Objectives: To estimate and compare the effects of Aloe vera and diclofenac on systolic blood pressure and renal functions of hypertensive rats. Place and duration of study: This study was conducted at Post Graduate Medical Institute Lahore, Sargodha Medical College, Sargodha and Department of Pharmacy, University of Sargodha for the period of three months. Material & Methods: Male Sprague Dawley rats (n=24) were divided into four groups; Group A (Normal control), Group B (Hypertensive control), Group C (Aloe vera treated) and Group D (Diclofenac treated). Hypertension was induced in groups B, C and D by 20% sucrose diet in 8 weeks. After induction of hypertension, distilled water, dried Aloe vera gel 400 mg/kg and diclofenac 12 mg/kg were given orally to group B, C and D respectively for 2 weeks as a single morning dose. Body weight and systolic blood pressure were measured weekly, while serum creatinine, creatinine clearance and urinary proteins were estimated and compared at 0, 8 and 10 weeks. Data was analyzed using SPSS 23 and p value of ?0.05 was considered significant. Results: Diclofenac decreased body weight of rats non-significantly and increased systolic blood pressure significantly (p< 0.03) whereas Aloe vera increased body weight significantly (p<0.012) and had no significant effect on systolic blood pressure. Diclofenac treated group showed deterioration of renal function as compared to Aloe vera treated group numerically. Conclusion: Aloe vera may be safer anti-inflammatory agent than diclofenac for treatment of chronic inflammatory conditions if the patient also has hypertension or renal disease.

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Impaired renal functions in Pakistani cohort of rheumatoid arthritis

Cited by 4 publications

References 21 publications

Diagnostic and therapeutic delay in Rheumatoid Arthritis patients: Impact on disease outcome

Diagnostic and therapeutic delay in Rheumatoid Arthritis patients: Impact on disease outcome

Differentiating active from Inactive Sacroiliitis in ankylosing spondylitis by combination of DWI and Magnetization Transfer Imaging

Comparative Evaluation of Aloe vera and Diclofenac on Body Weight, Blood Pressure and Renal Function of Hypertensive Rats

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