Chronic Interstitial Nephritis due to 5-Aminosalicylic Acid

Agharazii, Mohsen; Marcotte, Jean; Boucher, D; Noël, Raphaële; Lebel, Marcel

doi:10.1159/000013480

Cited by 24 publications

(15 citation statements)

References 12 publications

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“…Partial improvement or even complete recovery of renal function after steroid administration has been reported by several authors. [51][52][53][54][55][56]58,59,69,73,[75][76][77][78] However, other studies have been unable to demonstrate a beneficial effect of these immunosuppressive drugs. 8,52,58,79 Nevertheless, it has been suggested that a trial of high-dose steroid (60 mg/day or 1 mg day/kg for up to 3 months) may be recommended in patients whose renal function does not respond to drug withdrawal alone.…”

Section: Management Of Renal Impairment Due To 5-asa Treatmentmentioning

confidence: 99%

“…8,18,52,59,61,63,64,70,71,73,76 -80,93 Other authors have reported only partial improvement of renal function after drug withdrawal. 21,51,[53][54][55][56]68,69,72,74,75,77,81,82 Finally, although most case reports indicate reversibility after cessation of the drug, in some cases permanent clinical kidney dysfunction has been observed. 55,56,58,63,65,69,77,79 Thus, it has been calculated that Ϸ10% of the patients with 5-ASA nephrotoxicity will develop end-stage renal disease.…”

Section: Is Renal Impairment Due To 5-asa Treatment Reversible?mentioning

confidence: 99%

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5-Aminosalicylates and renal function in inflammatory bowel disease

Gisbert

González-Lama

Maté

2007

Inflammatory Bowel Diseases

195

144

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Nephrotoxicity has been described in some patients with inflammatory bowel disease (IBD) treated with 5-aminosalicylic acid (5-ASA). Studies with 5-ASA treatment in which serum creatinine or creatinine clearance was measured regularly show that nephrotoxicity is exceptional (mean rate of only 0.26% per patient-year). There have been several case reports, including 46 patients, of renal disease associated with 5-ASA treatment in patients with IBD. 5-ASA treatment-related nephrotoxicity is reported most often within the first 12 months, but also delayed presentation after several years has been shown. The absence of a clear relationship between 5-ASA dose and the risk of nephrotoxicity suggests that this complication is idiosyncratic rather than dose-related. Most of the patients with renal disease associated with 5-ASA treatment suffered interstitial nephritis, with symptoms and signs being nonspecific, which may delay detection for many months. The nephrotoxicity potential of mesalazine and sulfasalazine seems to be similar. The risk with different oral preparations of 5-ASA is probably too small to influence the choice of agent. Mesalazine should be withdrawn when renal impairment manifests in a patient with IBD; if this does not result in a fall in serum creatinine, then renal biopsy should be considered. A trial of high-dose steroid may be recommended in patients whose renal function does not respond to drug withdrawal. The optimal monitoring schedule of serum creatinine in patients receiving 5-ASA treatment remains to be established, as there is no evidence to date that either the test, or the frequency of testing, improves patient outcomes.

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Section: Management Of Renal Impairment Due To 5-asa Treatmentmentioning

confidence: 99%

Section: Is Renal Impairment Due To 5-asa Treatment Reversible?mentioning

confidence: 99%

5-Aminosalicylates and renal function in inflammatory bowel disease

Gisbert

González-Lama

Maté

2007

Inflammatory Bowel Diseases

195

144

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“…Parenchymal kidney disease is rare but has been well documented in the worldwide literature as case reports describing GN (7)(8)(9)(10), minimal-change disease (11,12), secondary amyloidosis (13)(14)(15), and interstitial nephritis (16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

The Histopathologic Spectrum of Kidney Biopsies in Patients with Inflammatory Bowel Disease

Ambruzs

Walker

Larsen

2014

Clinical Journal of the American Society of Nephrology

155

146

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“…The use of 5-aminosalicylic acid (5-ASA or mesalazine), the active moiety of sulphasalazine, has greatly replaced the use of sulphasalazine. Although 5-ASA has a significantly reduced toxicity compared to sulphasalazine, there have been reports of nephrotoxicity, therefore presenting a dilemma regarding its use as maintenance therapy in this setting [61].…”

Section: Discussionmentioning

confidence: 99%

Immunoglobulin A Nephropathy and Ulcerative Colitis

Trimarchi¹,

Iotti²,

Iotti³

et al. 2001

Am J Nephrol

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The immune response has largely been implicated in the pathogenesis of inflammatory bowel disease (ulcerative colitis and Crohn’s disease) and immunoglobulin A nephropathy. We present a 26-year-old woman with a long past history of asymptomatic macroscopic hematuria who later developed several episodes of bloody stools and abdominal pain. A colonic biopsy disclosed ulcerative colitis and a renal biopsy was consistent with immunoglobulin A nephropathy. Immunoglobulin A nephropathy is the most common glomerulonephritis, being end-stage renal disease a rare but the most serious complication. It can be primary or secondary, but the association between both entities is unusually observed. We discuss the possible immunologic mechanisms involved and believe the initial immunologic derangement originates in the bone marrow. We suggest both conditions must be considered when either a patient with ulcerative colitis and micro- or macrohematuria or with renal involvement and a past history of diarrhea or abdominal pain presents.

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Chronic Interstitial Nephritis due to 5-Aminosalicylic Acid

Cited by 24 publications

References 12 publications

5-Aminosalicylates and renal function in inflammatory bowel disease

5-Aminosalicylates and renal function in inflammatory bowel disease

The Histopathologic Spectrum of Kidney Biopsies in Patients with Inflammatory Bowel Disease

Immunoglobulin A Nephropathy and Ulcerative Colitis

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