*Renal co-morbidity is common in patients with rheumatic disease based on regular assessment of serum and urine parameters of renal function. *When patients present with both arthritis and renal abnormalities the following questions have to be addressed. 1.Is kidney disease a complication of rheumatic disease or its management, or are they both manifestations of a single systemic autoimmune disease? 2. Is rheumatic disease a complication of kidney disease and its management? (Mineral bone disorder CKD –MBD) 3. How do rheumatic disease and kidney disease affect each other even when they are unrelated?.