What is your preferred initial treatment strategy for patient with new diagnosis of seropositive RA who has end-stage renal disease?  

My initial response is to make sure that the diagnosis of RA is correct. Onset of arthritis in a patient with end-stage renal disease could be from other causes maybe even related to the renal disease itself such as gout or CPPD. If this is truly RA, then the safest approach for initial management...