Renal function was not impaired by treatment with 5-aminosalicylic acid in rats and man

Diener, U.; Tuczek, Hans-Volker; Fischer, Christine; Maier, Karlernst; Klotz, Ulrich

doi:10.1007/bf00505331

Cited by 33 publications

(11 citation statements)

References 19 publications

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“…Approximately one-third of rats given single intravenous injections of large doses of 5-aminosalicylic acid (216-878 mg/kg) developed papillary necrosis [17]. Diener et al [18] and Berryman et al [19] treated animals orally or rectally with 166-800 mg/ kg per day 5-aminosalicylic acid for up to 2 weeks and found no biochemical or histological evidence of renal injury. However, more prolonged treatment for 6-12 months led to papillary necrosis in both rats and dogs [20].…”

Section: Discussionmentioning

confidence: 97%

Interstitial nephritis from mesalazine: case report and literature review

Arend

Springate

2004

Pediatric Nephrology

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We report a new case of biopsy-confirmed mesalazine-induced interstitial nephritis in an 18-year-old male with ulcerative colitis. His renal function improved with drug discontinuation and corticosteroid treatment. An English literature review revealed an additional 22 cases of this complication that, taken together, showed (1) a male predominance, (2) an absence of specific symptoms or findings on urinalysis, (3) a 61% frequency of residual chronic renal insufficiency with 13% of patients developing end-stage renal disease, and (4) an apparent favorable response to steroid therapy. We conclude that patients receiving 5-aminosalicylates should be routinely monitored with serum creatinine measurements to prevent this uncommon but potentially serious adverse drug reaction.

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Section: Discussionmentioning

confidence: 97%

Interstitial nephritis from mesalazine: case report and literature review

Arend

Springate

2004

Pediatric Nephrology

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“…7,28 As previously mentioned, it has been suggested that in most cases renal failure was caused by an acute or chronic interstitial nephritis, which may be an idiosyncratic and doseunrelated adverse event.…”

Section: Type Of Nephrotoxicity Related With 5-asa Treatmentmentioning

confidence: 90%

5-Aminosalicylates and renal function in inflammatory bowel disease

Gisbert

González-Lama

Maté

2007

Inflammatory Bowel Diseases

199

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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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“…At present, there are few studies which have included measurements of tubular function in patients treated with 5‐ASA compounds. Some have described tubular dysfunction, 11 –13 while others have found no abnormality 14 , . 15 Recently, it has been reported that the use of sulphasalazine in accumulated doses above 1000 g increases the urinary excretion of tubular enzymes 16 .…”

Section: Discussionmentioning

confidence: 99%

“…Some have described tubular dysfunction, 11±13 while others have found no abnormality. 14,15 Recently, it has been reported that the use of sulphasalazine in accumulated doses above 1000 g increases the urinary excretion of tubular enzymes. 16 However, these studies have had methodological problems, in particular in measuring urinary enzymes.…”

Section: Discussionmentioning

confidence: 99%