arterial hypertension, rheumatoid arthritis, chronic kidney disease.


The purpose of the work is to establish the dependence of systemic hemodynamic parameters in patients with rheumatoid arthritis (RA) in combination with arterial hypertension (AH) and decreased renal function.

Materials and methods. The results of studying the data of 99 patients, who were divided into two groups of patients: a) patients with RA in combination with hypertension and glomerular filtration rate (GFR) <60 mm/min/1.73 m2, b) with RA in combination with hypertension and GFR ≥60 mm/min/1.73m2. Laboratory (levels of rheumatoid factor, C-reactive protein (CRP) and creatinine) and instrumental (office blood pressure measurement, ambulatory monitoring of blood pressure (ABPM)) examination methods were carried out.

Results and their discussion. Patients with RA in combination with hypertension and GFR <60 mm/min/1.73m² are characterized by an increase in blood pressure (BP) more pronounced at night (p <0.05), which corresponds to the frequent definition of Night-peackers and Non- dippers (34.8% each). The presence of a more pronounced decrease in renal function causes worse control of both systolic and diastolic blood pressure (on average by 12.2%, p<0.01) and a higher degree of damage to target organs at night (on average by 15.1%, p<0.001). In patients with decreased renal function, insufficient blood pressure control is determined by female gender, older age, visceral manifestations, longer duration of RA and hypertension, and RA activity and seropositivity (p<0.05). The need to take non-steroidal anti-inflammatory drugs and glucocorticosteroids corresponds to an increase in the chances of blood pressure increase at night.

Conclusions. An increase in blood pressure in patients with RA combined with hypertension and a decrease in renal function is more significant at night, characterized by worse blood pressure control and a greater vascular load on organs and systems at night, indicating the need for stricter control of blood pressure during sleep in this cohort patients In patients with RA in combination with hypertension and GFR <60 mm/min/1.73m², Nightpeackers and Non-dippers are more frequently detected, which is prognostically more unfavorable for the development of nocturnal “vascular catastrophes”.


Agca R, Heslinga SC, Rollefstad S, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017;76:17–28.

Bandyopadhyay D, Banerjee U, Hajra A, Chakraborty S, Amgai B, Ghosh RK, Haddadin FI, Modi VA, Sinha K, Aronow WS, Deedwania P, Lavie CJ. Trends of Cardiac Complications in Patients With Rheumatoid Arthritis: Analysis of the United States National Inpatient Sample; 2005-2014. CurrProblCardiol. 2021 Mar; 46(3):100455.

Barnabe C, Martin BJ, Ghali WA. Systematic review and meta-analysis: anti-tumor necrosis factor alpha therapy and cardiovascular events in rheumatoid arthritis. Arthritis Care Res (Hoboken) 2011;63:522–529.

Chebotareva NV, Guliaev SV, Androsova TV, Milivanova LU. [Chronic kidney disease in rheumatoid arthritis patients: prevalence, risks factors, histopathological variants]. TerArkh. 2019 May 15;91(5):129-133. Russian. doi: 10.26442/00403660.2019.05.000255. PMID: 32598687.

Hickson LJ, Crowson CS, Gabriel SE, McCarthy JT, Matteson EL. Development of reduced kidney function in rheumatoid arthritis. Am J Kidney Dis. 2014 Feb;63(2):206-13. doi: 10.1053/j.ajkd.2013.08.010. Epub 2013 Oct 4. PMID: 24100126; PMCID: PMC3944015.

Kapoor T, Bathon J. Renal Manifestations of Rheumatoid Arthritis. Rheum Dis Clin North Am. 2018 Nov;44(4):571-584. doi: 10.1016/j.rdc.2018.06.008. Epub 2018 Sep 7. PMID: 30274624.

Kochi M, Kohagura K, Shiohira Y, et al. Inflammation as a Risk of Developing Chronic Kidney Disease in Rheumatoid Arthritis. PLoS One. 2016;11:e0160225

Lewandowski B, Klimiuk PA, Kita K, Sierakowski S. Nerki w reumatoidalnymzapaleniustawów [Kidneys in rheumatoid arthritis]. Pol MerkurLekarski. 2004 Jan;16(91):73-7. Polish. PMID: 15074028.

Paudyal S, Yang FM, Rice C, Chen CC, Skelton M, Bethel M, Brown S, Nahman NS Jr, Carbone L. End-stage renal disease in patients with rheumatoid arthritis. Semin Arthritis Rheum. 2017 Feb;46(4):418-422.

Ponticelli C, Doria A, Moroni G. Renal disorders in rheumatologic diseases: the spectrum is changing (Part 1: connective tissue diseases). J Nephrol. 2021 Aug;34(4):1069-1080.

Roubille C, Richer V, Starnino T, et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74:480–489.

SumidaK, MolnarMZ, PotukuchiPK, HassanF, ThomasF, YamagataK, Kalantar-ZadehK, KovesdyCP. Treatment of rheumatoid arthritis with biologic agents lowers the risk of incident chronic kidney disease. Kidney Int. 2018 May;93(5):1207-1216. doi: 10.1016/j.kint.2017.11.025. Epub 2018 Mar 2. PMID: 29409725; PMCID: PMC5911428.



How to Cite

Kondratyuk В., Stakhova А., & Berzin О. (2023). FEATURES OF SYSTEMIC HEMODYNAMICS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN COMBINATION WITH ARTERIAL HYPERTENSION DEPENDING ON THE STAGE OF RENAL DYSFUNCTION. Actual Problems of Nephrology, (30-31), 63–68. https://doi.org/10.37321/nefrology.2022.30-31-07