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Renal manifestations in a cohort of pediatric patients with inflammatory bowel disease
Afroditi Kourti1, Chrysoula Kosmeri1, Aikaterini Chira1
1Department of Paediatric Gastroenterology, Hepatology and Nutrition, 3(rd) Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Insights
Renal manifestations occur in 16% of pediatric inflammatory bowel disease (IBD) patients, including glomerulonephritis and IBD-related kidney damage. Early detection is crucial for managing these uncommon IBD complications.
Area of Science:
- Pediatric Nephrology
- Gastroenterology
- Inflammatory Bowel Disease (IBD)
Background:
- Renal involvement is an uncommon complication of pediatric inflammatory bowel disease (IBD).
- Early identification and management of renal manifestations in IBD are essential.
Purpose of the Study:
- To characterize the spectrum of renal involvement in pediatric patients with IBD.
- To reduce diagnostic delays and improve management of renal complications in pediatric IBD.
Main Methods:
- Retrospective analysis of renal function in pediatric IBD patients (<18 years).
- Data collected from January 2019 to January 2023.
- Inclusion of urinalysis and further investigations for abnormal findings.
Main Results:
- 16% of 75 pediatric IBD patients exhibited renal manifestations.
- Urinalysis abnormalities included proteinuria, hematuria, and glycosuria.
- Diagnoses comprised glomerulonephritis, medication-induced renal damage, pyelonephritis with tubulointerstitial nephritis, thin basement membrane disease, IBD-related renal involvement, and amyloidosis-induced chronic renal failure.
Conclusions:
- Clinicians must recognize the potential for renal manifestations in pediatric IBD.
- Awareness facilitates early diagnosis and prevention of renal complications.
- Prompt management can mitigate long-term renal damage in IBD patients.
Background And Study Aims:
Renal involvement in inflammatory bowel disease is rather uncommon. This study aims to describe the spectrum of renal involvement in pediatric patients with IBD and reduce delay in detection and management.
Patients And Methods:
This is a retrospective study of the renal function of all patients, aged <18 years, who have been followed for IBD in our pediatric gastroenterology department from January 2019 till January 2023.
Results:
From the 75 IBD patients included in this study 16 % had renal manifestations. The urinalysis revealed proteinuria in 7 patients, proteinuria and hematuria in 3 and proteinuria and glycosuria in 2 patients. All 12 patients with abnormal urinalysis underwent further investigation in order to determine the cause of renal damage and the results are as follows: 2 patients had glomerulonephritis and in other 2 patients renal damage was due to medication adverse effect, 1 had pyelonephritis in combination with chronic active tubulointerstitial nephritis and another 1 had thin basement membrane disease. Three patients had IBD-related dependent renal involvement and 1 resulted in chronic renal failure due to amyloidosis.
Conclusions:
It is important for all clinicians to be aware of the possibility of renal manifestations in IBD patients for the early diagnosis and prevention of these manifestations and complications.
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