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Risk Factors for Chronic Kidney Disease in Patients With Crohn's Disease
Andres Rodriguez1, Maria Alejandra Quintero2, Hajar Hazime2
1Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Insights
Patients with Crohn's disease (CD) who have kidney stones or more than two surgeries face a significantly higher risk of developing chronic kidney disease (CKD). Early monitoring and hydration are key for prevention.
Area of Science:
- Gastroenterology
- Nephrology
- Metabolomics
Background:
- Inflammatory bowel diseases (IBD), including Crohn's disease (CD), increase the risk of kidney complications.
- Identifying patients with CD at higher risk for chronic kidney disease (CKD) is crucial for timely intervention.
Purpose of the Study:
- To investigate the clinical and metabolomic factors associated with CKD development in patients with CD.
Main Methods:
- Matched case-control study comparing CD patients with and without CKD.
- Collected demographic, IBD, and kidney-related data.
- Performed univariate, multivariate analyses, and untargeted serum metabolomics.
Main Results:
- CKD is more prevalent in CD patients than ulcerative colitis patients.
- Kidney stones (10x risk) and >2 IBD surgeries (7.3x risk) significantly elevate CKD risk in CD.
- Elevated pro-inflammatory and kidney-injury metabolites found in CD patients with CKD.
Conclusions:
- Regular kidney function monitoring and adequate hydration are recommended for CD patients.
- CD patients with prior surgeries and kidney stones require particular attention for kidney health.
Background:
Patients with inflammatory bowel diseases (IBD), including Crohn's disease (CD), are at risk of complications, including kidney disease. It is important to identify IBD patients at higher risk of chronic kidney disease (CKD) to improve prevention and treatment. Here, we investigated the clinical and metabolomic characteristics of CD patients who develop CKD.
Methods:
We identified adult CD patients with (CD + CKD, n = 87) and selected CD patients without CKD (CD controls) matched by age, race, and gender. We collected data on demographic characteristics (age, smoking status, ethnicity, gender), IBD characteristics (diagnosis, Montreal classification, medication use, IBD-related surgeries, perianal disease), and kidney-related factors (primary sclerosing cholangitis, end-stage renal disease, hypertension, diabetes, organ transplantation, and nephrolithiasis). Univariate and multivariate analyses were conducted and odds ratios were calculated to identify risk factors for CKD. Serum samples were collected for untargeted metabolomic analysis.
Results:
Chronic kidney disease was far more common in CD patients than UC patients. Crohn's disease patients with kidney stones had a 10-fold higher risk of developing CKD than those without kidney stones. Crohn's disease patients with more than 2 IBD-related surgeries had a 7.3-fold higher risk of developing CKD than those who had not undergone surgery. There was no relationship between the number of biologics used or mesalamine use and the risk of CKD. The serum of CD + CKD patients had elevated levels of pro-inflammatory metabolites and those linked to kidney injury.
Conclusions:
We recommend regular kidney function monitoring and ensuring proper hydration to prevent or manage potential kidney-related complications in CD patients. Patients with resections and kidney stones are particularly vulnerable.
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