IngentaConnect Renal tubular injury is present in acute inflammatory bowel disea...

Abstract:

Background

: 5-aminosalicylic acid (5-ASA) has been associated with renal complications in inflammatory bowel disease. Renal function is typically monitored using serum creatinine; however, significant disease may predate increases in creatinine. Aims

: To identify whether markers of early renal disease (urinary albumin, α-1-microglobulin [α-1-M] and N-acetyl-β-D-glucosaminidase [NAG], and serum cystatin C) are useful in the assessment of renal function in inflammatory bowel disease patients receiving 5-ASA. Methods

: Twenty-one patients with a new diagnosis of inflammatory bowel disease were investigated. Samples were taken at diagnosis, and at 3-monthly intervals after the commencement of 5-ASA, for 1 year. Results

: Mean creatinine clearance was 100 mL/min and did not change following treatment. Inflammatory bowel disease was not associated with albuminuria. Urinary N-acetyl-β-D-glucosaminidase and α-1-microglobulin at diagnosis were increased in 10 (48%) and 11 (52%) patients, respectively: treatment was not associated with consistent changes in urinary protein excretion. There was a significant correlation between cystatin C and creatinine clearance both at diagnosis (r=-0.533, P=0.0275) and combining the initial and follow-up data (r=-0.601, P < 0.01), but not between creatinine and creatinine clearance (P > 0.05). Conclusions

: Tubular proteinuria is an extra-intestinal manifestation of inflammatory bowel disease irrespective of 5-ASA treatment. Tubular proteins are not useful predictors of an adverse renal response to 5-ASA. Serum cystatin C may be an improved marker of glomerular filtration rate in this setting.

Document Type: Research article

DOI: 10.1046/j.1365-2036.2001.01041.x

Affiliations: 1: Department of Gastroenterology, East Kent Hospitals NHS Trust, Kent and Canterbury Hospital, Canterbury, Kent 2: Department of Clinical Biochemistry, East Kent Hospitals NHS Trust, Kent and Canterbury Hospital, Canterbury, Kent 3: The South-West Thames Institute for Renal Research, St Helier's Hospital, Carshalton, Surrey

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Renal tubular injury is present in acute inflammatory bowel disease prior to the introduction of drug therapy