We studied 76 patients with rheumatoid arthritis who had autopsies performed at the University of Utah and Salt Lake Veterans Administration Medical Center. The most common pathological finding in the kidney was interstitial fibrosis (46%) and internal proliferation of the arterioles in the absence of hypertension (54% of the cases). Renal amyloidosis was only found in 7% of the patients. Azotemia (creatinine above 2 mg/dl) was found in 9% of the patients but was not clinically significant. In addition uremia was not a frequent cause of death in patients with rheumatoid arthritis.