Renal disease is a well-recognized cause of ill health and death in
patients with rheumatoid arthritis. The most common cause of toxic
effect on the kidneys is the drugs used treat arthritis. Gold and
penicillamine may lead inflammation (glomerulonephritis) of the kidneys,
in between 10 and 30 % of patients. Anti-inflammatory drugs that are
used for pain relief are also associated with the development of kidney
failure and inflammation of the kidney.
A second major but diminishing cause of renal disease in rheumatoid
arthritis is amyloidosis. There is now also good evidence that
rheumatoid arthritis may be associated with the development of a
glomerulonephritis. The main types described are a proliferative
glomerulonephritis with or without IgA deposits, and a focal segmental
necrotizing glomerulonephritis of the vasculitic type.