Association of Inflammatory Bowel Disease with Incident Immunoglobulin A Nephropathy

Takashin Nakayama; Hidehiro Kaneko; Akira Okada; Yuta Suzuki; Katsuhito Fujiu; Norifumi Takeda; Hiroyuki Morita; Norihiko Takeda; Akira Fukui; Takashi Yokoo; Hideo Yasunaga; Masaomi Nangaku; Kaori Hayashi

doi:10.2215/CJN.0000000000000457

Association of Inflammatory Bowel Disease with Incident Immunoglobulin A Nephropathy

Clin J Am Soc Nephrol. 2024 Apr 11. doi: 10.2215/CJN.0000000000000457. Online ahead of print.

Authors

Takashin Nakayama¹, Hidehiro Kaneko^{2

3}, Akira Okada⁴, Yuta Suzuki^{2

5}, Katsuhito Fujiu^{2

3}, Norifumi Takeda², Hiroyuki Morita², Norihiko Takeda², Akira Fukui⁶, Takashi Yokoo⁶, Hideo Yasunaga⁷, Masaomi Nangaku⁸, Kaori Hayashi¹

Affiliations

¹ Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
² Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
³ Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan.
⁴ Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁵ Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Saitama, Japan.
⁶ Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
⁷ Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
⁸ Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.

PMID: 38600627
DOI: 10.2215/CJN.0000000000000457

Abstract

Background: There have been scarce epidemiological data on the relationship between inflammatory bowel disease and the incidence of Immunoglobulin A (IgA) nephropathy. In this study, we assessed whether inflammatory bowel disease was associated with a higher risk of developing IgA nephropathy using a large-scale epidemiological cohort.

Methods: We retrospectively analyzed 4,311,393 adults enrolled in the JMDC Claims Database (previously known as the Japan Medical Data Center database), a nationwide epidemiological database in Japan. The definitions of IgA nephropathy and inflammatory bowel disease (ulcerative colitis or Crohn's disease) were based on International Classification of Diseases-10th Revision codes. Individuals who had a prior history of IgA nephropathy were excluded. Study participants were categorized into two groups according to the presence of inflammatory bowel disease. Clinical outcomes were collected between January 2005 and May 2022. The primary outcome was incident IgA nephropathy.

Results: Median (interquartile range) age was 44 (36-53) years, and 2,497,313 (58%) were men. Inflammatory bowel disease was observed in 18,623 individuals (0.4%). Over a median follow-up of 1,089 (532-1,797) days, there were 2,631 incidences of IgA nephropathy and 22 incidences in individuals without and with inflammatory bowel disease, yielding incident ratios with 95% confidence intervals of 1.74 (1.68-1.81) and 3.43 (2.26-5.21), respectively. Kaplan-Meier curves and the log-rank test showed that a cumulative incidence of IgA was higher in individuals with inflammatory bowel disease compared to those without (log-rank p=0.003). Multivariable Cox regression analysis demonstrated that individuals with inflammatory bowel disease were at higher risk for incident IgA nephropathy (Hazard ratio 1.96, 95% confidence interval 1.29-2.99).

Conclusions: We demonstrated the potential association of inflammatory bowel disease with higher risk of developing IgA nephropathy in a general population.

Abstract

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