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Sulfasalazine-Induced Crystalluria Causing Severe Acute Kidney Injury
Michael Durando1, Hannah Tiu2, James Soo Kim3
1Department of Internal Medicine, Emory University, Atlanta, GA; Division of Nephrology, Department of Internal Medicine, University of Arizona, Tucson, AZ.
Sulfasalazine treatment can cause kidney stones (nephrolithiasis) in patients with inflammatory bowel disease. Maintaining hydration is crucial to prevent these potentially under-reported renal complications.
Area of Science:
- Nephrology
- Gastroenterology
- Pharmacology
Background:
- Sulfasalazine is an anti-inflammatory drug used for autoimmune diseases like inflammatory bowel disease (IBD) and rheumatoid arthritis.
- It metabolizes into sulfapyridine and 5-aminosalicylic acid (5-ASA), with efficacy linked to intestinal 5-ASA levels.
- Renal complications are known for 5-ASA derivatives (e.g., mesalamine) but are less recognized for sulfasalazine.
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