Validación del Timed Up and Go Test como Predictor de Riesgo de Caídas en Sujetos con Artritis Reumatoidea: Parte II: Validez Concurrente y Predictiva / Validation of the Timed Up and Go Test as Predictor of Risk of Falls in Subjects with Rheumatoid Arthritis: Part II: Concurrent and Predictive Validity

Introducción: Los sujetos con Artritis Reumatoidea (AR) tienen un elevado riesgo de caídas respecto a la población sana. El Timed Up and Go test (TUG) es utilizado para predecir el riesgo de caídas pero no ha sido validado en sujetos con AR. Objetivos: El objetivo primario fue establecer la validez predictiva y la validez concurrente a velocidad habitual y máxima segura en sujetos con diagnóstico de AR. El objetivo secundario fue establecer si el TUG tiene mayor valor predictivo evaluado a velocidad habitual o a velocidad máxima segura. Sujetos y método Los sujetos fueron ingresados mediante muestreo no probabilístico consecutivo. Para la validez concurrente se correlacionó el TUG con la Berg Balance Scale (BBS) y el Test de Marcha de 10 metros (TM10m). La validez predictiva fue calculada utilizando curva de características operativas para el receptor y el área bajo la curva. Resultados: Se evaluaron 115 participantes para la validez concurrente y 98 para la predictiva. Las correlaciones entre el TUG a velocidad habitual y el TUG a velocidad máxima segura con la BBS y el TM10m resultaron fuertes (rango de -0,65 a -0,78). La capacidad predictiva del TUG resultó baja tanto a velocidad habitual como a velocidad máxima segura. Conclusión: El TUG en sus dos versiones presentó una fuerte validez concurrente al ser comparado con la BBS y el TM10m. El TUG presentó una baja validez predictiva tanto a velocidad habitual como a velocidad máxima segura para predecir el riesgo de caídas en sujetos con AR.

Background: Subjects with Rheumatoid Arthritis (RA) have a high risk of falling. The Timed Up and Go test (TUG) is used to predict the risk of falls but it has not been validated in subjects with RA. Purpose: The primary objective was to establish the predictive validity and the concurrent validity of TUG at the preferred walking speed or fastest speed possible as a predictor of falls in subjects with RA. The secondary objective was to establish if the TUG has a higher predictive value evaluated at the preferred walking speed or fastest speed possible. Subjects and method: The subjects were admitted by consecutive non-probabilistic sampling. To establish the concurrent validity, the TUG was correlated with the Berg Balance Scale (BBS) and the 10-meter Walk Test (TM10m). Predictive validity was calculated using the operating characteristics curve for the receiver and the area under the curve. Results: 115 participants were evaluated for concurrent validity and 98 for predictive validity. The correlations between the usual speed TUG and fastest speed TUG with the BBS and the TM10m were strong (range from -0.65 to -0.78). The predictive capacity of the TUG was low at both normal speed and maximum safe speed. Conclusion: The TUG in its both versions presented a strong concurrent validity compared to the BBS and the TM10m.The TUG presented a low predictive validity both at normal speed and at maximum safe speed to predict the risk of falls in subjects with RA.

Renal manifestation in patients with rheumatoid arthritis / 대한내과학회지

BACKGROUND/AIMS: Although renal manifestations are often involved in patients with rheumatoid arthritis (RA), the causal relationship between RA and renal manifestations has not been clearly defined. The prevalence and causes of renal manifestations in patients with RA were investigated in this study. METHODS: The clinical data from 457 patients with RA and who were admitted to Hanyang University Hospital between 2001 and 2005 were retrospectively analyzed. Renal manifestations were defined as proteinuria (> or =300 mg/day) or azotemia (serum creatinine > or =1.7 mg/dL), with or without hematuria. RESULTS: Renal manifestation was present in 82 (17.9%) out of 457 RA patients. Among them, proteinuria was observed in 81 (17.7%), azotemia in 37 (8.1%) and hematuria with either proteinuria or azotemia in 35 (7.7%). For the cases with proteinuria, the amount of preteinuria was 1353+/-207 (mean+/-SD) mg/day. There was no significant correlation between the degree of proteinuria and the duration of RA. For the cases with azotemia, the serum creatinine was 3.98+/-0.35 mg/dL. The presence of azotemia had no significant association with the duration of RA (14.4+/-1.5 vs. 11.6+/-1.2 years, respectively). When the etiology of the renal manifestation was classified into primary and secondary renal disease, the latter included diabetic nephropathy in 13 (15.9%), hypertensive nephrosclerosis in 8 (9.8%), drug induced chronic tubulointerstitial disease in 11 (13.4%) and AA amyloidosis in 2. Renal biopsy revealed 10 cases of primary glomerulopathy, including IgA nephropathy in 3, membranous nephropathy in 2, mesangial proliferative glomerulonephritis in 1, focal segmental glomerulosclerosis in 1 and chronic sclerosing glomerulonephritis in 3. CONCLUSIONS: The prevalence of chronic kidney disease in patients with RA is high, although direct renal invasion by RA is very rarely encountered. Renal biopsy would be of great help to identify the various causes of renal manifestations in patients with RA.