DIALYSIS TREATMENT IN PATIENTS WITH RHEUMATOID-ARTHRITIS

The results of dialysis treatment in 24 rheumatoid arthritis patients, 20 chronic rheumatoid arthritis (RA) and 4 juvenile rheumatoid arthri tis (JRA), were analysed. Presence of secondary amyloidosis, renal fun ction, morbidity and survival were examined. Amyloidosis was present i n 13 patients. Especially among amyloidosis patients, renal function d eclined rapidly in the last year before dialysis started. On average, 63 days per patient-year were spent in the hospital, 58% was dialysis- related, mainly due to vascular access problems. Hospitalization was e ven more widespread in amyloidosis patients (79 days, 72% dialysis-rel ated). Median survival in RA patients with amyloidosis was 11 months; in RA patients without amyloidosis this was 29 months. Two-year surviv al was only 1 out of 10 for the RA amyloidosis patients; for the RA no n-amyloidosis patients this was 5 out of 6 (p < 0.01). Cardiovascular causes of death were most frequent. In conclusion, high morbidity and low survival make RA patients with amyloidosis a high-risk group on re nal replacement therapy.