Serum Adiponectin in Relation to Endothelial Dysfunction and Atherosclerosis in Rheumatoid Arthritis Patients with Renal Dysfunction and Influence on Cardiovascular Risk

Rheumatoid arthritis (RA) is a very common autoimmune disease in the populationwhich leads to progressive destruction of the joints. Cardiovascular diseases isthe common causes of death in RA patients. An unfavorable prognosis in patients with RA can be associated with kidney damage. The development of chronic kidney disease (CKD) in RA can be associated with cardiovascular pathology, while renal pathology itself is a risk factor for cardiovascular diseases.Purpose: To evaluate serum level of adiponectin and its relation to endothelial dysfunction and atherosclerosis in rheumatoid arthritis patients with renal dysfunction and prevalence on cardiovascular risk in these patients.Materials and method: This study was done with52 patients with established diagnosis of RA divided into two groups {group of rheumatoid arthritis (RA) patients with renal dysfunction and group of RA patients without renal dysfunction}. Serum adiponectin level were measured, GFR was calculated. Determination of flow mediated vasodilation was performed and assessment of atherosclerosis and cardiovascular risk.Results: In RA patients with renal dysfunction serum adiponectin level was significantly higher (p<0.05). EDVD was significantly lower (p<0.05) than in RA patients without renal dysfunction. There was increase in cardiovascular risk in RA patients with renal dysfunction.Conclusions: In this study patients with rheumatoid arthritis and more in those with renal dysfunction high adiponectin level was found and in spite of its cardioprotective effect, it has paradoxical effect in these patients with endothelial dysfunction changes and increased cardiovascular risk and mortality with high significant correlation to kidney function.