Microproteinuria in patients with inflammatory bowel disease: Is it associated with the disease activity or the treatment with 5-aminosalicylic acid

Poulou, Androniki; Goumas, Konstantinos; Dandakis, D.; Tyrmpas, Ioannis; Panagiotaki, Maria; Georgouli, Androniki; Soutos, D.; Archimandritis, Athanasios

doi:10.3748/wjg.v12.i5.739

Cited by 31 publications

(25 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found no statistically significant association between baseline microalbuminuria and the occurrence of a relapse of CD. This is in contrast with the study by Mahmud et al [1] that shows a strong correlation between microalbuminuria and clinical markers of disease activity, but in agreement with others [12,13,14]. The differences could be attributed to varied disease activity and number of relapses.…”

Section: Discussionsupporting

confidence: 84%

“…Due to the low rate of relapses, we could not evaluate the severity of microalbuminuria during relapse. Different studies have shown that microalbuminuria is present in a considerable percentage, between 6 and 12.9% of IBD patients showing higher concentration in active disease [1,2,13]. Normally, this reflects renal glomerular damage, but in IBD it could reflect an extraintestinal manifestation of the disease [6,18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Normally, this reflects renal glomerular damage, but in IBD it could reflect an extraintestinal manifestation of the disease [6,18,19]. For example, Poulou et al [13] found a significant relationship between microalbuminuria and serum TNF-α levels in IBD patients, probably caused by increased renal microvascular permeability in response to circulating cytokines [13]. In concordance with other extraintestinal manifestations of chronic IBD, microalbuminuria may be a feature of the disease which is not universally present in all patients.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Microalbuminuria Is Not a Valuable Marker for Relapse in Crohn’s Disease

Horjus

Oijen²,

Davids³

et al. 2010

Digestion

View full text Add to dashboard Cite

Background: Previous reports correlated microalbuminuria with disease activity in patients with Crohn’s disease (CD). The aim of the present study is to determine the value of microalbuminuria as a marker for relapses in quiescent CD. Methods: In a 1-year prospective maintenance trial with oral budesonide in patients with CD in remission, microalbuminuria was measured at randomization, after 2, 6 and 12 months, plus at the time of a relapse. The association of microalbuminuria with the course of disease was analyzed with logistic regression analysis. Time-dependent Cox regression was undertaken to study the association between microalbuminuria and relapse. Results: We included a total of 139 patients. At randomization, microalbuminuria was present in 8 patients. During a 1-year follow-up, 29 patients relapsed and in 11% (3/29), microalbuminuria was present during the relapse. We found no statistically significant association between microalbuminuria and relapse (odds ratio 0.92, 95% confidence interval (CI) 0.76–1.13). Time-dependent Cox regression analysis also revealed no statistical predictive value for microalbuminuria (hazard ratio 1.29, 95% CI 0.37–4.39, p = 0.68). Conclusion: Microalbuminuria was moderately prevalent in quiescent CD patients, but it could not be associated with disease characteristics or the type of medication before randomization, nor as a predictor for relapses.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Microalbuminuria Is Not a Valuable Marker for Relapse in Crohn’s Disease

Horjus

Oijen²,

Davids³

et al. 2010

Digestion

View full text Add to dashboard Cite

show abstract

“…18 Poulou reported that subclinical renal damage was caused by IBD itself and not by 5-ASA. 19 A more recent review in 2007 concluded that 5-ASA nephrotoxicity seems to be idiosyncratic in nature rather than dose related to 5-ASA and exceptional. 20 In our study there was no difference concerning the intake of 5-ASA between the patients with RI and the control group.…”

Section: Discussionmentioning

confidence: 99%

Renal insufficiency in IBD — Prevalence and possible pathogenetic aspects

Primas

Novacek

Schweiger

et al. 2013

Journal of Crohn's and Colitis

View full text Add to dashboard Cite

Background and aims: Extraintestinal manifestations of parenchymatous organs like kidney are rarely noticed in Inflammatory Bowel Disease (IBD). The aim of this study was to investigate the prevalence of renal insufficiency (RI) in IBD and look for potential causative factors and pathogenetic aspects. Methods: The study consists of two parts; the first determined the prevalence of RI in IBD and the second possible causative factors. For the first part all patients with IBD who had been investigated at our institution in the period from March 2006 to December 2007 were included. For the second part 25 IBD patients with RI were matched with 50 IBD patients without RI. To determine causative factors several gastroenterologic and renal parameters were compared between these two groups. Results: Eleven out of 775 patients with IBD had RI, all of them suffering from Crohn's disease (CD). This led to a prevalence of 1.99% for patients with CD and of 0% for patients with ulcerative colitis (UC). Concerning IBD risk factors only duration of disease (p = 0.002) and length of resected small bowel (p = 0.004) had a significant impact. Two nephrologic parameters, recurrent urolithiasis and the number of interventions due to kidney stones, were risk factors for the development of RI (p = 0.03). Conclusions: RI is a rare (2%) but relevant complication in CD, not found in UC. Extensive small bowel resection and recurrent urolithiasis seem to be the major causative factors.

show abstract

“…In this respect, microalbuminuria values have been shown to fall when the disease is quiescent, 9,10 even though the patients were receiving 5-ASA treatment. 14 A recent observational prospective study revealed that renal impairment was observed in 2.2% of 1529 IBD patients followed for 1 year, both including patients with and without concomitant 5-ASA treatment. 16 More recently, a case-control analysis found that IBD patients who were 5-ASA users had an increased risk of renal disease.…”

Section: Proteinuria In Patients With Ibdmentioning

confidence: 99%

5-Aminosalicylates and renal function in inflammatory bowel disease

Gisbert

González-Lama

Maté

2007

Inflammatory Bowel Diseases

199

144

View full text Add to dashboard Cite

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.

show abstract

Microproteinuria in patients with inflammatory bowel disease: Is it associated with the disease activity or the treatment with 5-aminosalicylic acid

Abstract: Microproteinuria is mainly associated with UC and its activity but not affected by 5-ASA.

Cited by 31 publications

References 35 publications

Microalbuminuria Is Not a Valuable Marker for Relapse in Crohn’s Disease

Microalbuminuria Is Not a Valuable Marker for Relapse in Crohn’s Disease

Renal insufficiency in IBD — Prevalence and possible pathogenetic aspects

5-Aminosalicylates and renal function in inflammatory bowel disease

Contact Info

Product

Resources

About