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RISK FACTORS FOR RENAL CALCULI IN PATIENTS WITH CROHN'S DISEASE.

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Crohn's disease patients have a high risk of developing kidney stones (nephrolithiasis). Certain medications and disease location increase this risk, highlighting the need for regular screening to prevent kidney damage.

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Internal Medicine

Background:

  • Nephrolithiasis incidence is rising, with diet, obesity, and high protein intake as risk factors.
  • Crohn's disease (CD) is an inflammatory bowel disease that increases nephrolithiasis risk due to disease mechanisms and medications.
  • CD complications, including extraintestinal manifestations like kidney stones, significantly impact patient quality of life and can lead to renal failure.

Purpose of the Study:

  • To determine the prevalence of nephrolithiasis in Crohn's disease patients.
  • To identify risk factors for nephrolithiasis in this population, including medications, surgery, disease location, and activity.
  • To emphasize the importance of screening Crohn's disease patients for nephrolithiasis to prevent chronic kidney disease.

Main Methods:

  • Electronic medical records of 93 Crohn's disease patients were analyzed.
  • Data from patients treated between 2009 and 2010 at a specialized center were reviewed.
  • All patients underwent an initial ultrasound examination.

Main Results:

  • 37 out of 93 patients developed nephrolithiasis during the study period.
  • Significant risk factors identified included disease location (P=0.023) and use of ciprofloxacin (P=0.0001), corticosteroids (P=0.005), immunomodulators (P=0.001), and metronidazole (P=0.0005).
  • Surgical status, age, and gender were not found to be predisposing factors for renal calculi.

Conclusions:

  • Imaging methods are crucial for screening Crohn's disease patients for nephrolithiasis.
  • Screening should be performed regardless of the patient's surgical history.
  • Early detection and management of nephrolithiasis in Crohn's disease patients can help prevent progression to chronic kidney disease.