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RA and the kidneys

RA and Your Kidneys

Rheumatoid disease/arthritis is autoimmune and systemic. It causes the body’s immune system to attack and attempt to destroy synovial tissues throughout the body.

Hardest hit by RD’s widespread inflammation are the joints—and thus, the “arthritis” in the name of the disease.  But it may also affect your organs: the synovial linings of your heart, your lungs, your eyes, and your circulatory system.

The chronic inflammation RD causes may also affect the kidneys. According to a 2014 Mayo Clinic study, rheumatoid disease patients are more likely to develop chronic kidney disease than the average person.

The kidneys—two, bean-shaped, fist-sized organs in the low back—are the body’s workhorses, filtering waste molecules from the blood for excretion in the urine, regulating electrolytes (and salts) in the body, and maintaining the body’s pH balance. Chronic kidney disease causes a progressive loss of kidney function over months or years, eventually causing death.

There are several risk factors that the study, conducted over a 20-year period with 813 patients with RD and 813 without RD, illuminated.

The risk factors are:

  • Severe inflammation during the first year of rheumatoid disease. This is one of the reasons that rheumatologists like to treat the disease aggressively from diagnosis. The aim is to reduce inflammation as quickly as possible and prevent the disease from progressing further.
  • Corticosteroid use. Rheumatologists commonly prescribe corticosteroids to treat joint pain. The Mayo Clinic study suggests that doctors be more careful with these and other drugs for RD that may have an adverse effect on the kidneys over time.
  • High blood pressure. Heart disease is common among RD patients. The study suggests that RD patients with high blood pressure should work to lower it and keep it under control through regular exercise, a healthy diet, and medications if necessary.
  • Obesity, high blood pressure, and heart disease go hand in hand. If you’re overweight or obese, it’s a good idea to slim down to your optimum weight for your age, gender, height, and build to reduce the likelihood of developing these and, over time, chronic kidney disease.
  • High cholesterol. High cholesterol levels in the blood contribute to high blood pressure and heart disease.
  • High sodium levels. Too much salt in the blood also contributes to high blood pressure and heart disease, and in their turn, chronic kidney disease. Pay attention to the hidden salt in your foods—check labels on processed foods, and stay away from the salt shaker. Instead, eat a diet packed with fresh vegetables, whole grains, chicken and fish, eggs, beans and legumes, and limited dairy foods, like milk and cheese. Use plant-based fats like olive or canola oil for cooking and eating. Drink lots of water and stay away from sugary foods except for the occasional, rare treat.

Other drugs, including some NSAIDs (Non-steroidal Anti-Inflammatory Drugs) may affect kidney function, so the study suggests that doctors and patients use them with care. The study further suggests that patients have blood tests and urine analysis once a year or more to check for kidney problems.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • memadeit
    9 months ago

    I have Ra and work in a dialysis center as a tech. My kidney funtions are going down and im heading twards an “AKI”. (kidney injury) so I talked to one of the Drs that comes in. It looks like my one med that Im taking for RA is well known for AKIs. Great, wonderful….. The sad part is the medican works wonders for me.

  • Wren moderator author
    5 months ago

    Hi memadeit! Thank goodness you noticed that your kidney function was changing and that you talked to a doctor about it. I’m sorry that the drug that may be causing the problem is also the one that works so well to keep your RA under control! I wonder if it might be worthwhile to speak to your rheumatologist about trying another, less problematic drug? I do “get” that you might not want to change!
    I hope this finds you feeling as well as possible. Thank you for taking the time to share your situation with us. It’s a good heads-up about researching these drugs and weighing the possible risks of taking them–or not taking them, since slowing or stopping RA’s progression, as well.
    Do please let us know how you’re doing.

  • DebbieH
    5 months ago

    I took methotrexate from 2011 to 2017 and August 2017 I end up in the hospital with my kidneys at 6%. Thought I was just super tired from the RA since June right after my routine bloodwork and the end of August I thought I had a sore throat went to ER and was in stage 4 kidney failure and the methotrexate ate my esophagus, throat a d mouth leaving with one giant canker sore in my mouth and throat. I could not drink or eat for a week and did three rounds of dialysis before I was able to leave the hospital two weeks later. My kidneys a year later are at 56% thanks to lots and lots of prayers. I am now considered chronic kidney disease which sucks but I am thankful that I am still here. I am trying to warn as many people as I can about methotrexate. That does don’t tell you the side effects. The FDA.GOV says there have been many deaths from the drug. If this is the drug you are on, get off of it asap! I’ve been off all RA drugs for a year and am doing so much better. I am so afraid to try another one. For any questions about any drug make sure to check it out on first. Take care andi hope you are better.

  • Wren moderator author
    5 months ago

    What a terrifying experience, DebbieH! I’m so sorry you went through it, but glad that you’ve recovered some of your kidney function. The drugs available to treat RA are powerful and yes, do sometimes cause side effects in some people. Others do quite well without problems at all. Like the disease itself, the treatments for it are unpredictable.
    I’m really glad you’re doing so much better without drug-related treatment, and I wish you nothing but the best going forward. Thank you very much for sharing your story. It’s sobering and thought-provoking, and you really bring home how important it is that we research these treatments ourselves and talk to our doctors before starting them. It’s the only way we can weigh the benefits and risks.
    Be well and stay in touch, please?

  • Nina Winterbottom moderator
    5 months ago

    Debbie, I’m so sorry you had this horrible experience and were blindsided by this side effect. I’m very thankful that you were about to regain some kidney function, but dealing with chronic kidney disease sounds difficult on top of RA. One’s treatment choice is quite personal and must come with understanding of these side effects. I am glad you’re doing better now and hope that continues to be the case. – Nina, Team

  • Tich
    2 years ago

    Very good article you’ve written Wren. My Ankylosing Spondylitis was diagnosed at 52 yoa, but many symptoms (and HLA-B27) were present at 22. At 30 I donated my right kidney to my brother. Why aren’t organ donors screened for RD?

  • Shirley Sanders
    2 years ago

    I read the list and have many of the items listed. I passed a kidney stone last week . The most painful thing ever.I hope others educate themselves on this issue and be proactive.

  • Lawrence 'rick' Phillips
    3 years ago

    Wren, as you know diabetes is a leading cause of kidney issues. When RA was heaped on top of it for me, I need to be especially careful. My best advice is to ask the doctors of kidney testing at least once a year. catching it early is better than later and after all what is one more vial at the blood draw.

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