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Renal involvement in children and adolescents with inflammatory bowel disease
Hea Min Jang1, Hee Sun Baek1, Jung-Eun Kim1
1Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Insights
Children with inflammatory bowel disease (IBD) experience higher rates of kidney complications, including hematuria and proteinuria. Early detection through regular urine screening is crucial for managing these renal issues in pediatric IBD patients.
Area of Science:
- Pediatric Nephrology
- Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Inflammatory bowel disease (IBD) incidence is rising globally.
- Renal complications are increasingly reported in pediatric IBD patients.
- Early identification of kidney issues in children with IBD is vital.
Purpose of the Study:
- To evaluate clinical manifestations of renal complications in pediatric IBD patients.
- To facilitate early detection and prompt treatment of kidney problems in children with IBD.
- To understand the spectrum of renal involvement in pediatric IBD.
Main Methods:
- Retrospective review of medical records for 456 children (<20 years) diagnosed with IBD since 2000.
- Analysis of patient demographics, IBD disease activity, and renal symptoms.
- Renal biopsy and histopathological examination for selected cases.
Main Results:
- 14.7% of pediatric IBD patients exhibited kidney-related symptoms, significantly higher than controls.
- Common findings included isolated hematuria (38.8%) and proteinuria (44.8%).
- Immunoglobulin A nephropathy was diagnosed in 5 of 7 children who underwent renal biopsy.
Conclusions:
- Pediatric IBD patients have a higher likelihood of developing kidney-related symptoms.
- Regular urine screening and renal function evaluation are recommended for early detection.
- Prompt management of renal complications can improve outcomes in children with IBD.
Purpose:
The incidence of inflammatory bowel disease (IBD) is rapidly increasing, and several reports have described the renal complications of IBD. We sought to evaluate the clinical manifestations of renal complications in children with IBD in order to enable early detection and prompt treatment of the complications.
Methods:
We retrospectively reviewed the medical records of 456 children and adolescents aged <20 years who had been diagnosed with IBD since 2000. We analyzed patient age, sex, medication use, IBD disease activity, and clinical manifestations of renal symptoms.
Results:
Our study comprising 456 children with IBD included 299 boys (65.6%) and 157 girls (34.4%). The study included 346 children with Crohn disease and 110 children with ulcerative colitis. The incidence of kidney-related symptoms was 14.7%, which was significantly higher than that in normal children. We observed 26 children (38.8%) with isolated hematuria, 30 children (44.8%) with isolated proteinuria, and 11 children (16.4%) with hematuria and concomitant proteinuria. A renal biopsy was performed in 7 children. Histopathological examination revealed immunoglobulin A nephropathy in 5 children (71.4%). All children presented with mild disease and well-controlled disease activity of IBD.
Conclusion:
Children with IBD are more likely to show kidney-related symptoms than healthy children and adolescents are. Therefore, regular screening of urine and evaluation of renal function in such children are necessary for early detection of renal complications.
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