Inflammatory Bowel Disease With Chronic Kidney Disease and Acute Kidney Injury

Mengyi Liu; Yanjun Zhang; Ziliang Ye; Sisi Yang; Chun Zhou; Panpan He; Yuanyuan Zhang; Fan Fan Hou; Xianhui Qin

doi:10.1016/j.amepre.2023.08.008

Inflammatory Bowel Disease With Chronic Kidney Disease and Acute Kidney Injury

Am J Prev Med. 2023 Dec;65(6):1103-1112. doi: 10.1016/j.amepre.2023.08.008. Epub 2023 Aug 10.

Authors

Mengyi Liu¹, Yanjun Zhang¹, Ziliang Ye¹, Sisi Yang¹, Chun Zhou¹, Panpan He¹, Yuanyuan Zhang¹, Fan Fan Hou¹, Xianhui Qin²

Affiliations

¹ Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangzhou, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
² Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China; National Clinical Research Center for Kidney Disease, Guangzhou, China; State Key Laboratory of Organ Failure Research, Guangzhou, China; Guangdong Provincial Institute of Nephrology, Guangzhou, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China. Electronic address: pharmaqin@126.com.

PMID: 37572855
DOI: 10.1016/j.amepre.2023.08.008

Abstract

Introduction: It remains unclear whether inflammatory bowel disease is associated with long-term risk of chronic kidney disease (CKD) and acute kidney injury (AKI) in the general population.

Methods: A total of 417,302 participants, including 2,940 patients with ulcerative colitis and 1,261 patients with Crohn's disease, without previous CKD and AKI at baseline (2006-2010) from the UK Biobank were included. The study outcomes included incident CKD and AKI, ascertained by self-report data and data linkage with primary care, hospital admissions, and death registry records. Analysis was conducted in 2022.

Results: During a median follow-up of 12.5 years, 13,564 and 14,331 participants developed CKD and AKI, respectively. Compared with the hazard ratio for non-inflammatory bowel diseases, the hazard ratios for CKD and AKI related to inflammatory bowel diseases were 1.57 (95% CI=1.37, 1.79) and 1.96 (95% CI=1.74, 2.20) after adjustments for age, sex, and race and were 1.32 (95% CI=1.15, 1.51) and 1.70 (95% CI=1.51, 1.91) after further adjustments for biological, behavioral, and socioeconomic factors in addition to mental health and self-rated health. Similar results were found for patients with Crohn's disease (adjusted hazard ratio=1.38 (95% CI=1.09, 1.75) for CKD and 1.62 [95% CI=1.30, 2.02] for AKI) and those with ulcerative colitis (adjusted hazard ratio=1.29 (95% CI=1.09, 1.51) for CKD and 1.71 [95% CI=1.49, 1.97] for AKI) in the fully adjusted models. Genetic risks of kidney diseases did not significantly affect the association of inflammatory bowel disease with incident CKD and AKI (both p-interactions>0.05). The association between inflammatory bowel disease and the risk of incident CKD (p-interaction=0.010) and AKI (p-interaction<0.001) were stronger in younger participants than in older participants.

Conclusions: Inflammatory bowel disease was associated with higher risks for CKD and AKI, independent of genetic risks of kidney diseases.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acute Kidney Injury* / epidemiology
Acute Kidney Injury* / etiology
Aged
Colitis, Ulcerative* / complications
Colitis, Ulcerative* / epidemiology
Crohn Disease*
Humans
Inflammatory Bowel Diseases* / complications
Inflammatory Bowel Diseases* / epidemiology
Renal Insufficiency, Chronic* / epidemiology
Renal Insufficiency, Chronic* / etiology