Pediatric Inflammatory Bowel Diseases: Should We Be Looking for Kidney Abnormalities?

Inflamm Bowel Dis. 2018 Nov 29;24(12):2599-2605. doi: 10.1093/ibd/izy166.

Abstract

Background: Kidney disease has been reported in adults with inflammatory bowel disease (IBD) and is regarded an extraintestinal manifestation or more rarely a side effect of the medical treatment.

Methods: In this cross-sectional study we describe the extent of kidney pathology in a cohort of 56 children with IBD. Blood and urine samples were analyzed for markers of kidney disease and ultrasonography was performed to evaluate pole-to-pole kidney length.

Results: We found that 25% of the patients had either previously reported kidney disease or ultrasonographic signs of chronic kidney disease. The median kidney size compared with normal children was significantly reduced. In a multivariate linear mixed model, small kidneys significantly correlated with the use of infliximab, whereas the use of enteral nutritional therapy was associated with larger kidneys.

Conclusion: Children with IBD are at risk of chronic kidney disease, and the risk seems to be increased with the severity of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Mass Index
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy
  • Infliximab
  • Kidney / pathology*
  • Leukocyte L1 Antigen Complex / urine
  • Linear Models
  • Lipocalin-2 / urine
  • Male
  • Multivariate Analysis
  • Prednisolone
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / etiology
  • Renal Insufficiency, Chronic / physiopathology*
  • Ultrasonography

Substances

  • Leukocyte L1 Antigen Complex
  • Lipocalin-2
  • Prednisolone
  • Infliximab