Prevalence and Etiologies of Renal and Urinary Manifestations in a Large Cohort of Children With Inflammatory Bowel Disease

Abstract

Background and objectives: Renal and/or urinary manifestations (RUM) have been reported in pediatric patients with inflammatory bowel disease (IBD) but their incidence is unknown. The aims of this study were to assess the prevalence and causes of these manifestations in children with IBD and determine the causal link with 5-aminosalicylic acid (5-ASA) treatment. Methods: A retrospective observational study was performed with children with diagnosis of IBD. All children with RUM during follow-up and/or impaired renal function [estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2] were identified. Results: Of 228 included patients, 9 (3.9%) had a RUM during follow-up [follow-up: 5 years (1–12 years)] at a median age of 16 years (8–17 years). It concerned 7 of 171 patients with Crohn disease and 2 of 57 with ulcerative colitis. Seven patients were taking 5-ASA at the time of the RUM. Only 1 of them had an iatrogenic renal complication related to this treatment. Patients with RUM had a more severe disease with increased anti-tumor necrosis factor-α use (P = 0.031), more abscesses (P = 0.003), and a higher rate of digestive surgery (P = 0.04). For the whole cohort, a significant decrease in eGFR was found during follow-up (121 vs 107 mL/min/1.73 m2, P < 0.001). At the end of follow-up, 38 of 202 (19%) patients had an eGFR < 90 mL/min/1.73 m2. Conclusion: In children with IBD, RUM can occur, independently of treatment with 5-ASA. During follow-up, a significant decrease in eGFR was observed. We suggest monitoring renal function in all patients with IBD.

Effect and mechanism of total ginsenosides repairing SDS‑induced Drosophila enteritis model based on MAPK pathway

“…Their intestinal structure is similar to that of mammals and has become a classic animal model for studying intestinal inflammatory damage and intestinal immunity. Traditional IBD drugs such as 5-aminosalicylic acid and glucocorticoids are effective but have various side effects ( 34 ). In this context, the search and use of Chinese herbs is significant for the repair of IBD.…”