Without proper management, chronic inflammation related to rheumatoid arthritis can increase the risk of kidney disease.

As many as 1 in 4 people who have rheumatoid arthritis (RA) will develop kidney disease. If you have RA, it’s important to understand the risk and take steps to protect your health.

RA is a chronic, inflammatory type of arthritis that commonly affects the lining of the joints in your hands, knees, or ankles.

As RA progresses, it can affect more joints. If left untreated, RA-related inflammation may also begin to damage major organs in your body, including your skin, eyes, mouth, heart, blood vessels, lungs, liver, and kidneys.

RA does not necessarily cause kidney disease directly. But both inflammation and RA medication can increase your risk of kidney issues.

Inflammation

Inflammation is your body’s way of protecting itself when there’s something wrong, such as illness or injury. The inflammation helps heal injured or diseased tissue.

But over time, chronic inflammation related to RA can take a toll on your whole body, causing stress and damaging or destroying cells and tissues, including those in your kidneys. And people with advanced RA have a higher risk of poor kidney function.

Medication

While most RA medications are safe for your kidneys, certain treatment options may increase your risk of kidney disease if you have preexisting kidney issues. These treatments include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs such as ibuprofen and naproxen can reduce blood flow to your kidneys.
  • Corticosteroids: Corticosteroids such as prednisone can raise your blood pressure and worsen kidney disease.
  • Methotrexate: if your kidneys are not working well enough to properly filter this drug out of your body, it can build up in your bloodstream and cause problems.
  • Cyclosporine: This drug has been linked with decreased kidney function, but your kidney health may improve once you stop taking the drug.

However, the results of a 2022 study suggest that reducing underlying RA-related inflammation in your body with treatments such as biologics may help prevent the progression of chronic kidney disease. So it’s important to work closely with your doctor to weigh the risks and benefits of your RA medication.

Other risk factors for kidney disease

Kidney problems are more likely to develop if you have another health condition in addition to RA that’s making your kidneys work harder, such as:

  • diabetes
  • high blood pressure
  • heart disease
  • obesity

Be sure to review your overall health history with your doctor when discussing your risk of kidney problems.

One of the best ways to protect yourself from RA-related kidney issues is to manage the underlying inflammation in your body.

Your doctor will probably prescribe a type of medication called disease-modifying antirheumatic drugs (DMARDs). DMARDs work to control the inflammation from RA. You may also take over-the-counter NSAIDs to help with pain and inflammation.

Your doctor should also monitor you regularly for kidney problems. Kidney disease often does not cause symptoms until the more advanced stages, and the symptoms can be similar to RA symptoms (such as fatigue).

Your doctor can order routine blood or urine tests to make sure your kidneys are working properly. You can work with your doctor to develop a testing schedule based on your individual circumstances.

You and your doctor can also work together to develop a plan to reduce other risk factors for kidney disease. Talk with them about:

  • weighing the benefits and risks of your RA medication
  • managing your weight as needed
  • monitoring your blood pressure and finding ways to keep it at a healthy level
  • making any necessary dietary changes

Exercise can be helpful for managing most of these risk factors. Regular, gentle exercise can ease inflammation, help regulate your blood sugar and blood pressure levels, and help with weight management.

But it’s important that you don’t overdo it. Choose low impact or no-impact activities and rest when necessary. Your doctor or physical therapist can help you create an exercise regimen that’s easy on your joints.

RA is a chronic, progressive type of arthritis. Without proper management, RA can lead to other health problems, including kidney issues. Checking in regularly with your doctor and maintaining some healthy lifestyle habits can help you stay as healthy as possible.