INFLAMMATORY BOWEL DISEASE AND KIDNEY– IS THERE A CONNECTION?

Abstract

Cilj ove studije bio je ispitati imaju li bolesnici s upalnom bolesti crijeva u nekoj mjeri promjene na bubregu. Štoviše, ispitivali smo odnosi li se ta povezanost na aktivnu bolest crijeva. U ovoj presječnoj studiji okupili smo od rujna 2012. do rujna 2013. godine 50 bolesnika srednje dobi od 47,1±16,5 godina s dijagnozom upalne bolesti crijeva postavljenom na osnovi anamneze, endoskopskih, histoloških i radioloških nalaza. Aktivnost bolesti procjenjivali smo indeksom aktivnosti ulceroznog kolitisa (UC activity index, UCAI) i indeksom za Crohnovu bolest (Crohn’s disease index, CDAI). Bilo je 38% bolesnika s ulcertivnim kolitisom (UK) i 62% bolesnika s Crohnovom bolešću (CB). Učestalost abnormalne albuminurije bila je 21,1% u bolesnika s UK i 29% u onih s CB. Nađena je visoka negativna korelacija između trajanja bolesti crijeva i 24-h albuminurije u bolesnika s UK, kao i visoka korelacija između odnosa albumin-kreatinin (ACR) i zbira UCAI u bolesnika s UK, ali te korelacije nisu bile statistički značajne, vjerojatno zbog malog broja bolesnika s UK. S druge strane, procijenjena stopa glomerularne filtracije (estimated glomerular filtration rate, eGFR) pokazala negativnu korelaciju s aktivnošću bolesti u bolesnika s CB (r=-0,569; p=0,05), dok nije bilo statistički značajne korelacije između UK i eGFR (r=0,343; p=NS). Zaključujemo da je abnormalna albuminurija dosta česta u bolesnika s upalnom bolesti crijeva. Čini se da bolesnici s tom bolešću imaju do neke mjere oštećenje glomerula, pretežito oni s CB. Da se istraži ta povezanost potrebne su zajedničke prospektivne studije gastroenterologa i nefrologa.The aim of the present study was to investigate whether patients with inflammatory bowel disease (IBD) have some degree of renal involvement. Furthermore, we investigated whether this connection is related to active bowel disease. In this cross-sectional study, 50 patients diagnosed with IBD, mean age 47.1±16.5 years, were recruited from September 2012 to September 2013. The diagnosis of IBD was based on clinical history, endoscopic, histological and radiological findings. Disease activity was assessed using the UC activity indeks (UCAI) for ulcerative colitis (UC) and Crohn’s disease activity index (CDAI) for Crohn’s disease (CD). There were 38% of UC patients and 62% of CD patients. The prevalence of abnormal albuminuria in UC and CD patients was 21.1% and 29%, respectively. There was a high negative correlation between duration of bowel disease and 24-h albuminuria in UC patients, as well as a high correlation between albumin-creatinine ratio (ACR) and UCAI score in UC patients, but these correlations were not statistically significant, probably due to the small number of UC patients. On the other hand, estimated glomerular filtration rate (eGFR) showed negative correlation with disease activity in CD patients (r=-0.569; p=0.05), while there was no statistically significant correlation between active UC and eGFR (r=0.343; p=NS). In conclusion, abnormal albuminuria is quite frequent in patients with IBD. It seems that patients with IBD have some degree of glomerular damage, mainly those with CD. Collaborative, prospective studies conducted by gastroenterologists and nephrologists are needed to investigate this association