The field of rheumatology has advanced significantly in recent years to provide rheumatologists with an extensive array of medications to combat rheumatic joint conditions. In contrast to an older era where nonsteroidal anti-inflammatory drugs and other nephrotoxic agents were the mainstay of treatment, modern disease modifying anti-rheumatic drugs (DMARDs) vary considerably in their nephrotoxic potential and their use is not always precluded in populations with pre-existing chronic kidney disease (CKD). This review will explore in detail the safety and efficacy profiles of medications used to treat rheumatologic disease, specifically in the setting of CKD. Specifically, we discuss both traditional agents used, i.e., NSAIDs, corticosteroids and conventional synthetic DMARDs, as well as novel biologic DMARDs and targeted synthetic DMARDs. Anti-gout prescribing in CKD is also reviewed. We aim to provide practical guidance to rheumatologists, nephrologists and general physicians when prescribing these medications in the setting of CKD.

中文翻译：

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风湿病学和肾脏治疗

近年来，风湿病学领域取得了显着进步，为风湿病学家提供了一系列广泛的药物来对抗风湿性关节病症。与非甾体类抗炎药和其他肾毒性药物是主要治疗药物的旧时代相比，现代疾病缓解抗风湿药 (DMARD) 的肾毒性潜力差异很大，并且并不总是排除在有先天性肾病的人群中使用它们现有的慢性肾脏病（CKD）。本综述将详细探讨用于治疗风湿病的药物的安全性和有效性概况，特别是在 CKD 的情况下。具体而言，我们讨论了使用的传统药物，即 NSAID、皮质类固醇和常规合成 DMARD，以及新型生物 DMARD 和靶向合成 DMARD。还审查了 CKD 中的抗痛风处方。我们旨在为风湿病学家、肾病学家和全科医生在 CKD 情况下开具这些药物的处方时提供实用指导。