Possibilities of chondroprotective therapy of osteoarthritis in terms of preserving kidney function

L.N. Eliseeva¹, S.V. Kartashova², O.I. Zhdamarova¹, N.Yu. Tikhomirova¹, A.Yu. Blednova^{1 1}Kuban State Medical University, Krasnodar

²Research Institute of the Regional Clinical Hospital No. 1, Krasnodar 

Aim: to analyze the patterns of changes in the renal filtration function in patients with pain syndrome during knee osteoarthritis (OA) using therapeutic and surgical methods for pain management.

Patients and Methods: the study included 193 patients with Kellgren–Lawrence grade II-IV knee OA (mean age 61.23±6.64 years) with clinically significant joint pain syndrome (6 or more points according to VAS) and comorbid conditions, which were divided into 4 groups depending on the treatment: endoprosthetic replacement, arthroscopy, NSAIDs intake or injection therapy courses with chondroitin sulfate. The comparison group consisted of patients with hypertension without joint pathology receiving standard antihypertensive therapy. The creatinine level and estimated glomerular filtration rate (eGFR) were retrospectively and prospectively determined in the beginning and in the end (after 1.5–2.5 years) of the study. eGFR trend was evaluated based on 1 month. Besides, the need for NSAIDs intake was assessed.

Results: multidirectional changes in eGFR were established with a tendency to decrease in the majority of patients taking NSAIDs as analgesics. At the same time, the pain relief through surgical intervention, even with a temporary withdraw to take NSAIDs or by repeated courses of therapy using the parenteral form of chondroitin sulfate, prevents a decrease in eGFR or restores it to normal values in most patients.

Conclusion: determination of the eGFR trend calculated for 1 month allows to unify the control indicator during the follow-up of patients in real clinical practice. Dynamic evaluation of eGFR can be considered as an effective way to control the safety of analgesic therapy in pain forms of OA.

Keywords: knee osteoarthritis, glomerular filtration rate, chondroitin sulfate, endoprosthetics, nonsteroidal anti-inflammatory drug.

For citation: Eliseeva L.N., Kartashova S.V., Zhdamarova O.I. et al. Possibilities of chondroprotective therapy of osteoarthritis in terms of preserving kidney function. RMJ. 2022;6:24–29.