International Urology and Nephrology

, Volume 52, Issue 1, pp 147–154 | Cite as

Patients with rheumatoid arthritis have an increased risk of incident chronic kidney disease: a systematic review and meta-analysis of cohort studies

  • Sukit Raksasuk
  • Patompong UngprasertEmail author
Nephrology - Original Article



Patients with rheumatoid arthritis (RA) may have a higher risk of developing chronic kidney (CKD) compared with general population, but the data on this risk are still not well characterized. This systematic review and meta-analysis aimed to comprehensively investigate this association by reviewing all available studies.


A systematic review was performed using MEDLINE and EMBASE database from inception to July 2019 to identify all cohort studies that compared the risk of developing CKD after index date among patients with RA versus individuals without RA. Pooled risk ratio and 95% confidence interval (CI) were calculated using random-effect, generic inverse-variance method of DerSimonian and Laird.


A total of four cohort studies (three retrospective cohort studies and four prospective cohort study) comprising of 1,627,833 participants met the inclusion criteria and were included in the meta-analysis. The overall quality of the included studies was good. The risk of incident CKD was significantly increased among patients with RA with the pooled risk ratio of 1.52 (95% CI 1.28–1.80). The statistical heterogeneity was high with an I2 of 82%.


A significantly increased risk of incident CKD among patients with RA compared with individuals without RA was demonstrated in this study.


Rheumatoid arthritis Chronic kidney disease Meta-analysis Systematic review 


Author contributions

All authors had access to the data and a role in writing the manuscript.



Compliance with ethical standards

Conflict of interest

We do not have any financial or non-financial potential conflicts of interest.

Supplementary material

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Supplementary material 1 (DOC 32 kb)
11255_2019_2346_MOESM2_ESM.docx (15 kb)
Supplementary material 2 (DOCX 15 kb)
11255_2019_2346_MOESM3_ESM.doc (64 kb)
Supplementary material 3 (DOC 63 kb)


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
  2. 2.Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

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