Prevalence of preclinical renal dysfunction in obese Egyptian patients with primary knee osteoarthritis, preliminary data

Aim of the work: Obesity and the related metabolic syndrome cluster of cardiovascular risk factors have been associated with chronic kidney disease (CKD). Patients with knee osteoar-thritis (OA) are frequently obese and due to the combined effects of obesity and the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs); they may represent a high risk group for renal dysfunction. We aimed to detect preclinical renal involvement in obese patients with knee OA. Patients and methods: Forty patients with knee OA and a body mass index (BMI) >= 30 ( mean age 43.5 +/- 3.7 years) not on chronic NSAID use and forty age and sex matched non-obese controls were enrolled in this study. For all subjects anthropometric measures were taken. Laboratory assessment included fasting blood sugar, serum triglycerides, high density lipoprotein cholesterol (HDL), serum uric acid, urea, creatinine and microalbuminuria assay. For patients with knee OA, knee radiographs were done and the disease severity was assessed according to Kellgren-Lawrence (K-L) scale.Tc-99 m DTPA was used for the measurement of the glomerular filtration rate (GFR) and the results were classified into normal and CKD according to Kidney-Dialysis Outcomes and Quality Initiative stages. Results: Among the patients' group, 26/40 (65%) had CKD compared to 12/40 (30%) subjects among the controls (P = 0.001). GFR correlated positively with HDL (r = 0.4; P = 0.02) and inversely with microalbuminuria and the severity of knee OA (r = -0.4; P = 0.02 for each). Conclusions: Obese patients with knee OA represent a high risk group for renal dysfunction. (C) 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society for Joint Diseases and Arthritis.