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Urolithiasis and crohn's disease.

Sandro Roberto da Silva Gaspar1, Tiago Mendonça2, Pedro Oliveira1

  • 1Department of Urology, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.

Urology Annals
|July 26, 2016
PubMed
Summary

Crohn's disease (CD) is linked to a 10-100 times higher risk of urolithiasis, particularly after bowel surgery. Early recognition and prevention plans are crucial for managing this common extraintestinal manifestation and preserving kidney function.

Keywords:
Calcium oxalate stonesCrohn's diseaseextraintestinal manifestationsinflammatory bowel diseaseulcerative colitis

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Area of Science:

  • Gastroenterology
  • Nephrology
  • Urology

Background:

  • Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD).
  • Urolithiasis is a significant complication of CD, often presenting as an extraintestinal manifestation (EIM).
  • Existing literature on the CD-urolithiasis association is largely outdated, necessitating an updated review.

Purpose of the Study:

  • To provide an updated description of the relationship between Crohn's disease and urolithiasis.
  • To highlight urolithiasis as a frequent EIM in CD patients, especially those with a history of bowel surgery.
  • To emphasize the need for proactive management and prevention strategies for stone disease in CD patients.

Main Methods:

  • A comprehensive literature search was conducted in Medline, Embase, and Cochrane databases.
  • Search terms included "CD," "renal calculus," "IBD," and "urolithiasis."
  • Articles published in English between 2000 and 2014 were selected for review.

Main Results:

  • Urolithiasis occurred in 10.5% of 901 reviewed CD patients.
  • The risk of urolithiasis in CD patients is 10-100 times greater than in the general population or ulcerative colitis patients.
  • Urolithiasis typically develops 4-7 years post-CD diagnosis, with calcium oxalate stones being most common; it is frequent in patients with ileostomies and multiple bowel resections.

Conclusions:

  • Urolithiasis is the most common EIM in Crohn's disease, particularly post-bowel surgery.
  • Prompt recognition and management are vital for patients with unexplained renal dysfunction, abdominal pain, or recurrent UTIs.
  • Implementing specific prevention plans can mitigate stone disease risk, preserve renal function, and improve quality of life for CD patients.