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Investigation of the Diagnostic Performance of Dimethyl Arginine Derivate and Lisosomal Enzymes in Patients with Rheumatoid Arthritis

Spasovski D, Alabakovska S, Jankulovski N, Bozinovski G, Bogdanovska S, Grcevska L, Sotirova T, Genadieva-Stavric S, Chaparovska D, Gjorcev A and Sadicario S

Introduction: Untreated Rheumatoid Arthritis (RA) has implications on renal tissue as one of the visceral manifestations of disease. Arthritis primarily damages the proximal renal tubules.

Aim: To compare the diagnostic values of laboratory variables; to find the predictive value of the positive and negative test and accuracy of the tests for Symmetric Dimethyl Arginine (SDMA), N-acetyl-β-D-glucosaminidase (NAG), microalbuminuria, rheumatoid factor (RF), C-reactive protein (CRP) andDisease Activity Score 28 index (DAS 28); and to detect the effect of untreated rheumatoid arthritis on glomerular and tubular function.

Patients and methods: Quantification of N-acetyl-β-D-glucosaminidase is used for colorimetric assay, ELISA method for detection of SDMA, immunoturbidimetry assay for microalbuminuria and agglutination test for RF. Serum and urine simples are examined in 70 participants (35 patients with untreated rheumatoid arthritis and 35 healthy individuals as control group).

Results: Of 35 examined patients with RA, we found presence of NAG enzymuria (sensitivity of the test; 37.14%) in 13, while microalbuminuria appeared in 4 patients (sensitivity of the test; 11.42%). SDMA was present in 26 patients (sensitivity of the test; 74.58%), while RF was detected in 17 patients (sensitivity of the test; 48.57%).

Conclusion: SDMA and NAG have higher sensitivity than microalbuminuria in the detection of asymptomatic renal impairment in untreated RA.

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