Abstract:
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder with
potential systemic complications including renal involvement. Microalbuminuria
represents early endothelial dysfunction and may indicate disease severity and
cardiovascular risk in RA patients. The aim of the study is to determine the prevalence of
microalbuminuria in patients with rheumatoid arthritis and to examine its correlation
with disease activity markers including rheumatoid factor (RF), erythrocyte
sedimentation rate (ESR), and C-reactive protein (CRP). Methods: The study included 40
patients with established rheumatoid arthritis diagnosed according to the 2020 American
College of Rheumatology-European Alliance of Associations for Rheumatology (ACR
EULAR) classification criteria. Patients underwent comprehensive clinical assessment
including detailed history, physical examination with tender and swollen joint counts, and
laboratory investigations. Microalbuminuria was assessed using spot morning urine
samples with albumin-to-creatinine ratio (ACR) method, defining microalbuminuria as
ACR more than or equal to 30 mg/g. Disease activity markers including ESR, CRP, and RF
were measured using standard laboratory methods. Statistical analysis was performed
using appropriate parametric and non-parametric tests, with p value less than 0.05
considered statistically significant. Results: Microalbuminuria was present in 8 out of 40
patients (20%). Patients with microalbuminuria demonstrated significantly elevated
inflammatory markers compared to those without microalbuminuria. Mean ESR was
48.8±13.7 mm/hr in the microalbuminuria-positive group versus 31.6±12.2 mm/hr in the
microalbuminuria- negative group (p=0.001). Mean CRP levels were 29.2±8.4 mg/L in
microalbuminuria-positive patients compared to 20.06±12.1 mg/L in microalbuminuria
negative patients (p=0.05). Rheumatoid factor showed a strong association with
microalbuminuria, with 100% (8/8) of microalbuminuria-positive patients being RF
positive compared to 62.5% (20/32) of microalbuminuria-negative patients (p=0.038).
Conclusion: Microalbuminuria was present in 20% of rheumatoid arthritis patients and
showed significant correlations with disease activity markers including ESR, CRP, and RF.
These findings establish microalbuminuria as a valuable biomarker of disease severity
and systemic inflammation in RA. Routine microalbuminuria screening should be
considered in RA patients, especially those with high disease activity or elevated
inflammatory markers.
